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August 1993

Picture of the Month

Author Affiliations

From the Department of Pediatrics, The Children's Hospital of Philadelphia (Pa) (Dr Tunnessen); Resident Division of Dermatology, Hahnemann University Hospital, Philadelphia (Dr Telang); Department of Pediatrics, Cooper University Medical Center, Camden, NJ (Dr Leong); and Department of Dermatology, St Christopher's Hospital for Children, Philadelphia (Dr Koblenzer).

Am J Dis Child. 1993;147(8):903-904. doi:10.1001/archpedi.1993.02160320105028

Denouement and Discussion 

Neonatal Lupus Erythematosus 

Manifestations  The neonatal lupus erythematosus (NLE) syndrome was first described in 1954.1 Since then approximately 200 cases have been reported in the literature, but it is a much more common disorder. The two most common manifestations of NLE are congenital heart block and cutaneous lesions, with approximately 50% of affected patients presenting with one or the other system involvement. It is uncommon for both heart and skin to be affected in the same infant.The cutaneous manifestations may be present at birth, but they much more frequently appear between ages 1 and 2 months. The appearance of skin lesions may be precipitated by sun exposure. The lesions most commonly appear on the face, scalp, and upper trunk. The lesions may appear as annular polycyclic or psoriasiform erythematous patches or plaques, sometimes with associated scale; as erythematous macules and patches; or as discrete, erythematous