• Pityriasis versicolor is a superficial fungal infection of the

skin caused by Malassezia furfur or Pityrosporum orbiculare

and is clinical in the presence of macules in the skin, skuama
and accompanied by itching.
• They tend to develop gradually and may join up to form
larger patches over time.
• Pityriasis versicolor usually on face, neck, body, upper arm,
armpits, thighs, and thighs lips
Epidemiology

• Pityriasis versicolor is a universal disease but is more prevalent in the

tropics due to high temperatures and humidity
• Attacking almost all ages, especially teenagers, most at the age of 16-
40 years.
Clinical Sign
• Skin disorders Pityriasis versicolor is very superficial and is found
primarily in the body.
• This disorder is seen as macular hypopigmentation or macular
hyperpigmation, irregular shape until regular, clear to diffuse borders.
• The spots are fluorescence when viewed with Wood's lamp.
• The papulo-vesicular form can be seen rarely. The disorder is usually
asymptomatic, so sometimes the patient does not know that he or
she is ill.
Clinical Sign
• In bright skin, the lesion is a light macular hyperpigmentation with a
fine skuama on the surface, especially in the upper body and forearm.
• This disorder is usually asymptomatic, only a cosmetic disorder. In
dark skin, a typical appearance of hypopigmented patches. The loss of
pigment is thought to have something to do with the production of
azelaic acid by yeast, which inhibits tironase and thus interferes with
the production of melanin.
• This is why hyperpigmentation lesions on pale skin are unknown.
Color variations that depend on the original skin color are the reasons
why the disease is called 'Versicolor’.
Clinical Sign
 How to diagnose
In addition to recognizing typical abnormalities caused by Malassezia fulfur
diagnosis Pityriasis versicolor should be assisted with the following tests:
1. Direct inspection with 10% KOH.
This examination shows a grouping of coccus, thick-walled yeast cells with rough,
often short-cut, rough mycelium, which would be more easily seen with the
addition of the Parker blue-black or lactafenol blue. The image of yeast and
mycelium is often described as "meat ball and spaghetti".
2. Inspection with Sinar Wood
Inspection with Sinar Wood, can give a color change in the entire area
of ​the lesion so that the limits of the lesions are more easily seen. The
affected area will show a golden yellow fluorescence to orange.
Treatment
1. Topical Treatment
2. Treatment should be thorough, diligent and consistent. Drugs that can be
used are:
• Selenium sulfide 1.8% in the form of shampoo 2-3 times a week. The drug
is rubbed on the lesion and allowed to stand for 15-30 minutes before
bathing
• Salisil spirits 10%
• Azole derivatives, for example: mikozanol, clotrimazole, isoconazole and
econazole in topical form
• Sulfur precipitatum in shake powder 4-20%
• Sodium Solution Tiosulfas 25%, applied 2 times daily after bathing for 2
weeks.
3. Systemic Treatment
Systemic treatment is given in the case of widespread Pityriasis versicolor or if topical drug use is unsuccessful.
Drugs that can be given are:
a. Ketoconazole : 200 mg per day for 10 days
b. Fluconazole : a single dose of 150-300 mg every week
c. Itraconazole : 100 mg per day for 2 weeks.

4. Hypopigmented Therapy (Leukoderma)

1. Liquor carbonas detergent 5%, morning / evening ointment
2. Medium and morning corticosteroid cream
3. Drying in the sun ± 10 minutes between the hours of 10:00 to 15:00

Pityriasis versicolor tends to relapse, so treatment should be repeated. Hypopigmentation areas need a
prolonged time for repigmentation, and this lasting defect should not be considered a treatment failure.
Prognosis
The prognosis is good in terms of healing, when the movements are
thorough, diligent and consistent. Treatment should be continued 2
weeks after the negative fluorescence with Wood's lamp examination
and direct negative preparation.