Neonatal Lupus Erythematosus

Joanna M. Burch, Lela A. Lee and William L. Weston

Disclosures

Dermatology Nursing. 2002;14(3) 

In This Article

Treatment

The treatment for the cutaneous lesions is strict sun avoidance and mid to low-potency topical steroids. Systemic steroids are not required for managing cutaneous lesions. Systemic antimalarial treatment is not advisable due to its potential toxicity and slow onset of action. The parents should be counseled that the lesions are transient and will likely resolve by 6 to 8 months, usually without any evidence they were present. Residual, persistent telangiectasias can be treated with the pulsed-dye laser.

In CHB, there is some evidence that dexamethasone is helpful in preventing hydrops fetalis, and may have some effect in less-severe cases of AV block. Third-degree block never regresses but there are cases of second-degree block improving. Jonzon found several occurrences of sudden death in a group of patients with congenital heart block who were symptom free. In half, there were no preceding symptoms. He recommended early implantation of a pacemaker as the treatment of choice for all patients with CHB (Brucato et al., 1999). However, there is no firm consensus regarding the management of CHB, either prenatally or after birth.

The infant should be referred to the appropriate pediatric specialist (cardiology, gastroenterology) for evaluation and treatment of extracutaneous manifestations.

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