Efikasi Terapi Topikal Kortikosteroid Ultrapoten, Solusio, dan Gel Timolol Maleat 0,5% Terhadap Hemangioma Infantil Superfisial

Abstract

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.

Formulation and Characterization of Timolol Maleate-Loaded Nanoparticles Gel by Ionic Gelation Method Using Chitosan and Sodium Alginate

“…Infantile hemangioma (IH) is the most prevalent vascular benign tumor in children with an incidence of about 4 to 10 % in the first year of life [1]. Although it will improve spontaneously, about 10 to 20 % of infants who have IH require interventions to prevent and reduce complications associated with the proliferation phase [2].…”