Answer

Answer to last month's Clinical Quiz

Question:
This one month old baby developed an erythematous annular eruption on his face. His mother was apparently in good health with unremarkable antenatal and perinatal history.

Answer:
B. Neonatal lupus erythematosus

Neonatal lupus erythematosus is caused by the placental transfer of autoantibodies, anti-Ro and anti-La in particular, from the mother. Although mothers of babies with neonatal lupus erythematosus (LE) invariably have positive serology, half of them have no clinical sign or symptom of LE.

Despite being termed neonatal LE, the rash can appear from birth to several months of age. It is characterised by multiple annular erythematous lesions on sun exposed areas, the face being the most commonly affected. Other systemic involvement includes heart block, thrombocytopenia and hepatosplenomegaly.

The rash will usually subside in a few months time without scarring. Mild topical steroids can be used and appropriate measures to avoid UV irradiation should be advised. Systemic steroid therapy is rarely required.

The winner of the November 2001 Clinical Quiz is
Dr. Fu Wing Chung