Background: Infantile hemangioma (IH) is the most common benign tumor in infancy. Most IHs resolve spontaneously and do not require treatment. Therapeutic intervention is necessary for life-threatening IH, tumors posing functional risks, ulceration, and severe anatomic distortion, especially on the face. Beta-blockers, most specifically propranolol, have been shown to induce involution of IH, which should be administered as early as possible to avoid potential complications. Purpose: To report a case of IH with visual impairment treated successfully using oral propranolol. Case: A 4-month-old girl weighing, 6.3 kg, with redness plaques on the right face since 3 weeks after birth. The lesions rapidly increased in size within 2 months, and the lesions on her right eyelid made it difficult to open her right eye. Dermatological examination showed erythematous plaques, compressible and varying in size and ptosis. The patient was diagnosed with periocular infantile hemangioma and was given oral propranolol therapy with an initiated dose 3x1 mg. The dose was increased gradually. The lesions were significantly decreased and she could open her right eye normally after 5 months of propranolol therapy. Discussion: Some cases of IH require early treatment. Early treatment is indicated for IH causing functional impairment. The use of propranolol in the management of IH is very effective in the reduction of the lesions and Has minimal side effects. Conclusion: Early diagnosis and intervention with propranolol for IH play an important role in determining the optimal outcomes.

Erythema multiforme (EM) is an uncommon acute mucocutaneous illness with target lesions primarily on the face and limbs. Slow-onset hypersensitivity reactions to infections (including herpes simplex virus and mycoplasma pneumonia) and medicines (including antibiotics, anticonvulsants, and nonsteroidal anti-inflammatory drugs) cause EM. A 4-year-old male with EM after taking metamizole, ampicillin, cloxacillin, and an unknown puffer, the major developed lip sores and blisters on various places of his body. Dermatological examination revealed haemorrhagic crusts on the lips. On both hands and feet, typical target lesions with central blisters, purplish red in color, well-defined boundaries, round to oval in form, and variable size were seen. There were erythematous macules and genital oedema. A blood test revealed higher levels of leucocytes and CRP. Serological testing revealed no IgG, IgM, or anti-HSV1&2 antibodies. The X-ray of the chest was normal. Clinical improvement occurred after elimination of suspected drugs and intravenous dexamethasone, gentamicin, and paracetamol, oral cetirizine, fusidic acid 2% cream, 0.9% NaCl compress, and sterile gauze. The diagnosis of EM was established based on the presence of multiple typical target lesions with central blisters, symmetrical distribution on the extremities (dorsal surfaces of hands and feet), and involvement of lip and genital mucosal lesions after taking drugs. Negative IgG and IgM Anti HSV 1&2 test results lead to the diagnosis of drug allergy-related Erythema Multiforme Major.

Urticaria is a skin disorder characterized by localized redness or edema of the mucosa followed by an itching sensation that subsides within a day. Proper treatment not only requires pharmacological treatment but also preventive measures to reduce the impact of risk factors that can worsen the patient's urticaria complaints. This study is an observational study with a retrospective approach that aims to evaluate the risk factors of acute and chronic urticaria patients at Allergy Immunology Division Dermatovenereology Outpatient Clinic Dr. Soetomo General Academic Teaching Hospital, Surabaya, Indonesia from 2018 to 2020. This study found 179 new urticaria patients with the number of acute urticaria patients 114 patients (63.7%) and chronic urticaria 65 patients (36.3%). The analysis was conducted based on the characteristics of the samples gender, age, atopic history with a p-value>0.05. There was a statistically significant correlation between Body Mass Index (BMI) (p=0.003). The multivariable logistic regression analysis showed BMI (OR=1.16; 95%CI=1.05-1.27; p=0.002) and history of allergic rhinitis (OR=4.32; 95%CI=1.25-14.86; p=0.020) were factors that played a significant role in the incidence of chronic urticaria.