Background: Infantile hemangioma (IH) may have implications on parental distress and cosmetic disfigurement. To date, ultrapotent corticosteroids are used as a treatment of choice for superficial IH. However, due to their side effects and sometimes lack of IH regression, it is necessary to find alternative topical therapies. Timolol maleate 0.5% solution and gel are nonselective β-blockers that could inhibit proliferation and trigger regression of IH. Objective: To evaluate the efficacy of topical ultrapotent corticosteroids and timolol maleate 0.5% solution and gel for superficial IH. Patients and Methods: The study design was prospective. Two hundred and seventy-eight patients diagnosed as having superficial IH were enrolled from the outpatient clinic of the Department of Dermatology and Venereology, Dr. Sardjito Hospital, Yogyakarta, Indonesia, from January 2009 to December 2014. Patients were divided into three groups: A = treated with topical ultrapotent corticosteroid, B = timolol maleate 0.5% solution and C = timolol maleate 0.5% gel. Patients were followed for 6 months to evaluate the lesion. Lesion size was measured from scaled photodocumentation with the software program ImageJ®. Results: There were significant differences in IH size after treatment with timolol maleate 0.5% solution compared with ultrapotent corticosteroids (p < 0.001) and timolol maleate 0.5% gel compared with ultrapotent corticosteroids (p < 0.001). There was no significant difference in IH lesions after treatment with timolol maleate 0.5% solution versus gel (p = 0.744). Conclusion: Timolol maleate 0.5% solution and gel were significantly superior to topical ultrapotent corticosteroids in size reduction of superficial IH.

Latar belakang. Terapi kortikosteroid ultrapoten menjadi terapi topikal standar untuk HI. Namun, kortikosteroid banyak efek samping dan respon yang kadang gagal, perlu alternatif terapi topikal lain. Solusio dan gel timolol maleat 0,5% merupakan beta bloker non selektif yang ternyata dapat menghambat proliferasi dan memicu regresi HI. Tujuan. Mengetahui efikasi terapi kortikosteroid topikal ultrapoten, solusio, dan gel timolol maleat 0,5% pada hemangioma infantil superfisial. Metode. Desain penelitian kohort retrospektif, dilibatkan 79 pasien HI superfisial dalam kurun waktu Januari 2011-Oktober 2015 di RSUP. Dr. Sardjito, Yogyakarta. Hasil. Perbandingan selisih luas antara ketiga kelompok didapatkan perbedaan yang bermakna antara solusio timolol maleat 0,5% dibandingkan kortikosteroid ultrapoten 0,5% (p<0,001). Gel timolol maleat 0,5% dibandingkan kortikosteroid ultrapoten (p<0,001). Perbandingan antara selisih luas lesi setelah terapi solusio dan gel timolol maleat 0,5% tidak berbeda secara bermakna (p=0,744). Kesimpulan. Efikasi solusio dan gel timolol maleat 0,5% lebih baik dibandingkan kortikosteroid topikal ultrapoten terhadap pengurangan luas lesi hemangioma infantil superfisial. Sari Pediatri 2016;17(6):428-34.Kata kunci: hemangioma infantil superfisial, kortikosteroid ultrapoten, solusio timolol maleat 0,5% Background. Ultrapotent corticosteroids is used as a standard topical treatment for IH. However, because of its many known side effects and its unpredictable response to IH regression, and sometimes fails, an alternative topical treatment is needed. Timolol maleat 0.5%, as solution or gel, is a nonselective beta-blocker that could inhibit proliferation and trigger regression of IH. Objective. To evaluate the eficacy of topical ultrapotent corticosteroids, timolol maleate 0.5% solution and gel for superficial IH. Methods. The study design was retrospective cohort study, involving 79 IH patients from the period of January 2011 to October 2015 in Sardjito Hospital, Yogyakarta. Result. There were significant differences of IH size after treated with timolol maleate 0.5% solution and timolol gel 0.5% compared with ultrapotent corticosteroids (both with p<0,001). There was no significant difference of IH lesion regression after treatment with timolol maleate 0,5% solution or gel (p=0,744). Conclusion. Timolol maleate 0.5% solution and gel therapy are significantly superior compared to topical ultrapotent corticosteroids for superficial IH lesion size reduction. Sari Pediatri 2016;17(6):428-34.

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Psoriasis tipe plak merupakan penyakit radang kulit kronik dan residif, memiliki dasar genetik dengan karakteristik gangguan pertumbuhan dan diferensiasi epidermis. Psoriasis tipe plak merupakan bentuk terbanyak yang diderita, mencapai sekitar 90% seluruh kejadian psoriasis. Tata laksana psoriasis derajat sedang dan berat umumnya dimulai dengan terapi kombinasi dan rotasi antara terapi topikal, fototerapi, sistemik nonbiologik. Apabila terapi-terapi tersebut dianggap tidak efektif dan kurang berespons, pemberian terapi sistemik biologik perlu dipertimbangkan. Metotreksat merupakan salah satu terapi sistemik nonbiologik konvensional yang mekanisme kerjanya adalah menghambat sintesis DNA, sehingga menghasilkan kerja antimitotik dan antiinflamasi di epidermis. Secukinumab adalah inhibitor IL-17A yang menunjukkan efikasi pada terapi psoriasis tipe plak derajat sedang hingga berat dan artritis psoriatik. Serial kasus ini melaporkan dua kasus psoriasis tipe plak yang diterapi dengan kombinasi  secukinumab 150 mg/4 minggu dan metotreksat 10 mg/minggu. Setelah 24 minggu didapatkan remisi psoriasis tipe plak mencapai PASI > 90 tanpa efek samping.Kata kunci:  agen biologik - metotreksat  - PASI - psoriasis tipe plak - secukinumab