Cutaneous sequelae in neonatal lupus: A retrospective cohort study

J Am Acad Dermatol. 2020 Aug;83(2):440-446. doi: 10.1016/j.jaad.2019.09.083. Epub 2019 Oct 15.

Abstract

Background: Cutaneous eruptions in neonatal lupus erythematosus (NLE) are thought to be self-resolving. Limited literature suggests cutaneous changes may persist.

Objective: To characterize cutaneous residua in NLE and identify predictors for their development.

Methods: A retrospective cohort study of patients with cutaneous NLE born between January 1980 and May 2017 was performed. Primary outcome was the proportion of patients with cutaneous residua. Secondary outcomes included associations/predictors of sequelae.

Results: At the last follow-up, at a mean age of 4 years (range, 0.5-18.7 years), 34% of 106 patients had cutaneous sequelae, 13% had telangiectasia, 17% had dyspigmentation, and 9% had atrophic scarring. Scarring at the last follow-up was significantly associated with the presence of skin lesions at birth (P < .001).

Limitations: This study was limited by the retrospective design, short follow-up duration in a subset of patients, and small sample size.

Conclusion: Cutaneous NLE can exhibit long-term cutaneous residua. These findings underlie the importance of accurate diagnosis, long-term monitoring, and appropriate counseling.

Keywords: atrophy; cutaneous sequelae; dyspigmentation; neonatal lupus erythematosus; scarring; telangiectasia.

MeSH terms

  • Adolescent
  • Atrophy / epidemiology
  • Atrophy / immunology
  • Atrophy / pathology
  • Atrophy / prevention & control
  • Child
  • Child, Preschool
  • Cicatrix / epidemiology*
  • Cicatrix / immunology
  • Cicatrix / pathology
  • Cicatrix / prevention & control
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / congenital*
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Erythematosus, Systemic / therapy
  • Male
  • Pigmentation Disorders / epidemiology*
  • Pigmentation Disorders / immunology
  • Pigmentation Disorders / prevention & control
  • Retrospective Studies
  • Skin / immunology
  • Skin / pathology*
  • Telangiectasis / epidemiology*
  • Telangiectasis / immunology
  • Telangiectasis / prevention & control

Supplementary concepts

  • Neonatal Systemic lupus erythematosus