A male infant aged 3 months was brought with a maculopapular, erythematous rash with scaling at the edges distributed symmetrically over the malar region, forehead, chin and forearms (Fig. 1). Heart rate was 60/min. Rest of the clinical examination was normal. He was born to a mother with Systemic Lupus Erythematosus (SLE). ECG was suggestive of complete heart block. Complete blood counts and metabolic profile were normal. ANA and DsDNA were negative. A diagnosis of Neonatal Lupus Erythematosus (NLE) was made.

Fig. 1. Erythematous maculopapular rash with peripheral scaling involving face and forearms.

NLE is a rare syndrome affecting infants of less than six months and having features of rash, cytopenias and complete heart block in infants born to mothers having Systemic Lupus Erythematosus and AntiRo and AntiLa antibodies. The rash appears a few days to weeks after birth and disappears spon-taneously after a few weeks leaving no scar. Pancytopenias are seldom serious and regress spontaneously. Congenital heart block may require permanent pacing eventually.

R.G. Holla,
Prabhat Kumar,
Army Hospital (Research & Referral),
Delhi Cantt, Delhi, India.