Pendahuluan

Tinea Versicolor is mild chronic infection of the skin caused by Malassezia yeasts, and
characterized by discrete or concrescent, scaly, discolored or depigmented areas mainly on the
upper trunk1. The genus Malassezia, formerly known as Pityrosporum, currently includes twelve
species of lipophilic basidiomycetous yeast: Malassezia furfur, Malassezia pachydermatis,
Malassezia sympodialis, Malassezia globosa, Malassezia restricta, Malassezia slooffiae,
Malassezia obtusa, Malassezia dermatitis, Malassezia nana, Malassezia yamatoensis, Malassezia
japonica, and Malassezia equi.2 As a yeast,the organism is a part of the normal follicular flora.It
produces skin lesion when it grows in the hyphal phase.Tinea versicolor commonly presents as
hypo or hyperpigmented and colesing skin macules on the trunks and the upper arms.Facial
lesion occurs fairly commonly in infants and immunocompromised patients.In the latter penile
lesion may occur as well.The disease may even occur on the scalps,palms and soles.3

It is a superficial mycosis that occurs worldwide, especially in tropical and subtropical regions.
In temperate regions, a higher incidence of PV occurs during summer and autumn.PV was first
recognized as a fungal disease in 1846 by Eichstedtand. 4

Epidemiologi
The prevalence of tinea versicolor in the United States is estimated to be 2%8% of the
population.The infection occurs more frequently in regions with higher temperatures and relative
humidity. Tinea versicolor has a worldwide prevalence of up to 50% in the hot and humid
environments and as low as 1.1% in colder climates. Incidence of tinea versicolor is the same in
all races, but the eruption is often more apparent in darker-skinned individuals due to resulting
alteration in skin pigmentation. No sex predominance is apparent. Tinea versicolor is most
common among adolescents and young adults.2 Research conducted and published in Indian
Journal Of Dermatology stated that of the total 139 patients clinically suspected of having
Pityriasis versicolor, the maximum number of patients i.e., 47 (33.81%) were in the age group of
21 to 30 years, followed by 29 (20.86%) patients who were in the age group of 31 to 40 years.
This is similar to the findings published by many workers.This could be explained by the fact

that sebum production is at its peak in this age group. There were 83 (59.71%) males and 56
(40.28%) females who were clinically suspected of having Pityriasis versicolor.5

Etiologi
The normal flora of the skin includes a number of morphologically distinct lipophilic yeasts. It
was thought that a single polymorphic yeast, Pityrosporum ovale, or two species, P. ovale and P.
orbiculare, were present, but it is now recognized that this genus name was invalid, and these
yeasts were reclassified in the genus Malassezia as a single species, M. furfur1. M. furfur can be
cultured from both affected and normal skin and is considered part of the normal flora,
particularly in sebumrich areas of the body. Experimental inoculation of Malassezia under
occlusion has resulted in infection.The resulting increase in humidity, temperature and CO2
tension appear to be important factors contributing to infection.While removal of occlusion
promotes healing of the eruption, the organism may still be cultured from clinically uninvolved
areas.Furthermore, this colonization of follicular structures facilitates a high recurrence rate. M.
furfur is a dimorphic, lipophilic organism that grows in vitro only with the addition of C12C14
fatty acids such as olive oil and lanolin. Under appropriate conditions, it converts from the
saprophytic yeast to the predominantly parasitic mycelial form, which causes clinical disease.
Factors predisposing to mycelial transition include a warm, humid environment, hyperhidrosis,
oral contraceptive, and systemic corticosteroid use, Cushings disease, immunosuppression, and
a malnourished state2