We report a 7-month-old white boy with neonatal lupus erythematosus (NLE), for whom diagnosis of his resolved rash was only possible after review of images of his skin lesions stored on his mother's smartphone.The boy was born at full term by vaginal delivery to a 34-year-old primigravida, following an uncomplicated pregnancy. At 5 weeks of age, he developed multiple scaly annular plaques on his face, chest and back, which over a few months increased in size and cleared centrally. The lesions were asymptomatic and resolved spontaneously when the child was 5 months old. They were not present at the time of examination in our dermatology clinic. However, we suspected NLE after review of photographs stored on his mother's smartphone (Fig. 1). These photographs enabled the correct diagnosis to be made and monitoring of the infant for potential serious sequelae to be planned. At presentation, the child had no hepatosplenomegaly or lymphadenopathy. Full blood count, liver function tests and electrocardiogram were normal. His mother was positive for antinuclear antibodies, double-stranded DNA (22 IU/mL; normal < 10 IU/ mL), and Ro 60, and negative for La, anti-smooth muscle, Jo-1, Scl 70, Sm/RNP, centromere, and IgG and IgM anticardiolipin antibodies. She was asymptomatic without history or clinical signs of systemic lupus erythematosus (SLE).NLE is an uncommon systemic autoimmune disease. It is caused by transplacental maternal immunoglobulin G anti-Ro, anti-La and/or anti-U1-ribonucleoprotein (anti-U1-RNP) autoantibodies against fetal heart, liver, platelets and rarely brain. Only 1% of Figure 1 Erythematous annular and scaly plaques on (a,b) the face and (c) the trunk. ª 2014 British Association of Dermatologists
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