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Case Profile
A newborn born who was delivered by cesarean section at 36+6 weeks' gestation had extensive purpuric erosions on his back, buttocks, forechest, arms, neck, and head after delivery. He was born flat and dull-complexion, requiring positive pressure ventilation for 3 minutes, after which hemodynamics remained stable.
The child's parents were not consanguineous married, and his mother was diagnosed with systemic lupus erythematosus at the age of 17 and was on prednisolone 5 mg, hydroxychloroquine 300 mg, and aspirin 100 mg daily throughout pregnancy, and the disease was relatively stable. Prenatally, fetal growth, amniotic fluid, and fetal scans were unabnormal.
Specialist examination: large purpuric erosions on the scalp, neck, back, forechest, arms, and buttocks, and the skin lesions on the back form a typical "X" shape.
Figure 1: (Cited from References)
Figure 2: Skin biopsy of dorsal purpura lesion (A) HE staining: atrophic epidermis, lined with mildly dense orthokeratin, with erythrocyte extravasation in the superficial and middle layers of the dermis; (B) HE staining: subepidermal blisters with mild basal vacuolar degeneration adjacent to the epidermis.
Figure 3: At 3 months of age, previous skin lesions heal with atrophic and hypertrophic scarring.
Q:
What is the most likely diagnosis?
A:
A. Staphylococcal scald skin syndrome
B. Neonatal candidiasis
C. Epidermolysis bullosa
D. Neonatal lupus erythematosus
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参考文献：[1]KAN S Y,ARUNACHALAM S,HO S,et al. A case of neonatal lupus erythematosus presenting with extensive erosions at birth,healing with extensive scarring[J]. JAAD Case Rep,2023,42(35-7.
Source of this article: Medical Community Skin Channel Editor-in-Charge: Moon
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