13例新生儿红斑狼疮的临床特征、皮损后遗表现

【摘要】 目的 探讨新生儿红斑狼疮（NLE）的皮损后遗表现,分析可能的相关因素。方法 回顾2016—2020年首都儿科研究所附属儿童医院皮肤科收集并长期随访的13例NLE,分析患儿及母亲临床特征、患儿皮损后遗表现。结果 13例皮损发病时间为出生后0 ~ 120 d,平均15 d,随访时间15 ~ 43个月,皮损形态主要为环状红斑、斑丘疹、鳞屑,皮损消退时间2 ~ 18个月（平均7.4个月）。6例皮损消退后出现色素异常表现,3例同时出现色素减退和色素沉着,2例仅有色素减退,1例仅有色素沉着,1例色素减退患儿在随访18个月后色素减退复色,未见毛细血管扩张以及萎缩或瘢痕。8例患儿母亲孕前无异常,4例患儿母亲抗ANA、抗SSA/Ro、抗SSB/La抗体均阳性。结论 NLE的皮肤受累可出现后遗皮肤表现,常见为色素异常,多数长期未消退,应注意患儿母亲可能存在的潜在性免疫系统异常。

Clinical manifestations and cutaneous sequelae of neonatal lupus erythematosus: 13 case reports

【Abstract】 Objective To investigate cutaneous sequelae of neonatal lupus erythematosus （NLE）, and to analyze possible related factors. Methods A total of 13 NLE patients with long-term follow-up were collected from Department of Dermatology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from 2016 to 2020, and clinical manifestations and cutaneous sequelae of these patients, as well as clinical manifestations of their mothers, were retrospectively analyzed. Results Skin lesions occurred in the 13 patients within 120 days after birth, with an average onset time of 15 days, and the follow-up duration ranged from 15 to 43 months. Skin lesions mainly manifested as annular erythema, maculopapules and scales, and subsided within 2 - 18 months （average, 7.4 months）. Pigmentation abnormalities occurred in 6 cases after subsidence of skin lesions, including 3 with both hypopigmentation and hyperpigmentation, 2 with hypopigmentation alone, and 1 with hyperpigmentation alone. One patient with hypopigmentation achieved repigmentation after 18 months of follow-up, and no telangiectasia, atrophy or scars were observed. No abnormalities were observed in the mothers of 8 patients before pregnancy, and the mothers of 4 patients were positive for antinuclear antibody, anti-SSA/Ro antibody and anti-SSB/La antibody. Conclusions Cutaneous sequelae can occur after skin involvement of NLE, and mainly includes pigmentation abnormalities, most of which can not subside after a long time. Attention should be paid to potential immune system abnormalities in the mothers of patients with NLE.