Neonatal lupus skin lesions often appear in the first few weeks of life, but may be present at birth. They are scaly lesions on the face, scalp and extremities, but nonscarring.
One to two-thirds of mothers of babies with NLE will develop rheumatic disease within 5 years. A Canadian study followed mothers of babies with cutaneous NLE and those with CHB for a mean of 7 years. A much greater percentage (75%) of mothers of babies with cutaneous disease developed symptomatic rheumatic disease; 56% of mothers of infants with CHB remained asymptomatic.
There have been case reports of infants with NLE going on to develop SLE as adolescents. Five of 57 patients reviewed in the NLE registry developed autoimmune syndromes within 6 years: autoimmune thyroiditis, juvenile rheumatoid arthritis, Raynaud's disease, and systemic lupus erythematosus.
About 1 in 200 women is positive for anti-Ro antibodies. The risk for mothers who are anti-Ro antibody positive to have an affected infant is about 0.5%. If the mother has a previously affected infant, the risk increases to about 20%, regardless of whether CHB or cutaneous NLE was present.
One percent of NLE patients develop hepatic disease. Thrombocytopenia or neutropenia is observed in about 10% of cases. Both usually resolve within weeks of birth.