Histopathologic characteristics of neonatal cutaneous lupus erythematosus: description of five cases and literature review.
BACKGROUND
Neonatal lupus erythematosus (NLE) is a disease associated with the transplacental transfer of maternal anti-Ro/SSA. The histopathologic characteristics of neonatal lupus have been described as compatible with cutaneous lupus based on isolated cases.


METHODS
We retrospectively review the available literature and compare them with findings obtained in seven biopsies of five cases.


RESULTS
Erythematous-desquamative lesions and urticaria-like lesions were observed in our series. Two cases showed both type of lesions. Vacuolar alterations at the dermoepidermal interface and adnexal structures were the histopathologic findings on erythematous-desquamative lesions, and a superficial and deep perivascular and periadnexal lymphocytic infiltrate was the major pattern in urticaria-like lesions. One case showed prevalence of eosinophils in the inflammatory infiltrate. Sixty cases have been reported previously. Sixty-five percent presented erythematous-desquamative and 29% urticaria-like lesions. Pathologic findings of erythematous-desquamative lesions were similar to those found in our series, but epidermal vacuolar changes were the predominant histopathologic finding in urticaria-like lesions of cases reported in the literature.


CONCLUSIONS
The majority of cases of NLE show vacuolar alteration at the dermoepidermal interface and adnexal structures. Some cases exhibit a superficial and deep perivascular and periadnexal lymphocytic infiltrate without epidermal alteration, and rare cases may have eosinophils in the infiltrate.
Peñate
Y
Y
Department of Dermatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain. ypenate@aedv.es
Guillermo
N
N
Rodríguez
J
J
Hernández-Machín
B
B
Montenegro
T
T
Afonso
J L
JL
Borrego
L
L
D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000473:pathology; D008178:Lupus Erythematosus, Cutaneous / Q000378:metabolism / Q000473:pathology*; D008297:Male; D012189:Retrospective Studies