title: A newborn with grouped facial skin lesions and subsequent seizures.
abstract: BACKGROUND
  Congenital grouped skin lesions are alarming signs of a variety of threatening diagnoses of quite different origin. The present case report shows an impressive clinical pattern of a neonate and illustrates the difficulty in differential diagnosis of mixed connective tissue disease and neonatal lupus erythematosus in newborns. This reported case is to our knowledge the first description of an unrecognized mixed connective tissue disease in the mother with an unusual clinical manifestation in the newborn, comprising skin lesions, neurological damage and non-typical antibody constellation.
  
  
  METHODS
  We report on a Caucasian female neonate from a perinatally asymptomatic mother, who presented with grouped facial pustular-like skin lesions, followed by focal clonic seizures caused by multiple ischemic brain lesions. Herpes simplex virus infection was excluded and both the mother and her infant had the antibody pattern of systemic lupus erythematosus and neonatal lupus erythematosus, respectively. However, clinical signs in the mother showed overlapping features of mixed connective tissue disease.
  
  
  CONCLUSIONS
  This case report emphasizes congenital Lupus erythematosus and mixed connective tissue disease as important differential diagnoses of grouped skin lesions in addition to Herpes simplex virus-infection. The coexistence of different criteria for mixed connective tissue disease makes it difficult to allocate precisely maternal and congenital infantile disease.
authors.affiliation: Department I - General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str,1, Tuebingen 72076, Germany. michaela.doering@med.uni-tuebingen.de.
authors.forename: Michaela
authors.initials: M
authors.lastname: Döring
authors.forename: Karin Melanie
authors.initials: KM
authors.lastname: Rohrer
authors.forename: Ilias
authors.initials: I
authors.lastname: Tsiflikas
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Buchenau
authors.forename: Marko
authors.initials: M
authors.lastname: Wilke
authors.forename: Rupert
authors.initials: R
authors.lastname: Handgretinger
authors.forename: Christian Friedrich
authors.initials: CF
authors.lastname: Poets
authors.forename: Rangmar
authors.initials: R
authors.lastname: Goelz
mesh_terms: D000974:Antibodies, Antinuclear / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D002545:Brain Ischemia / Q000473:pathology*; D003937:Diagnosis, Differential; D020938:Epilepsy, Partial, Motor / Q000209:etiology*; D005148:Facial Dermatoses / Q000175:diagnosis*; D005260:Female; D006561:Herpes Simplex / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000151:congenital / Q000175:diagnosis* / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008947:Mixed Connective Tissue Disease / Q000175:diagnosis*; D020151:Protein C Deficiency / Q000150:complications; D017411:Ribonucleoproteins, Small Nuclear / Q000276:immunology; D055517:snRNP Core Proteins / Q000276:immunology
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D017411:Ribonucleoproteins, Small Nuclear; C552127:SNRNP35 protein, human; D055517:snRNP Core Proteins