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Karakteristik klinis, sosial, dan lingkungan pasien dermatomikosis superfisial di Kabupaten Raja Ampat, Papua Barat dan divisi mikologi poliklinik ilmu kesehatan kulit dan kelamin Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta.

Latar belakang: Dermatomikosis superfisial merupakan infeksi jamur terbatas pada epidermis, rambut, kuku, dan membran mukosa. Tiga tipe infeksi tersering disebabkan oleh jamur dermatofita, Malassezia sp., dan Candida sp., sementara tipe yang lebih jarang adalah tinea nigra, piedra, dan infeksi kapang nondermatofita. Telah diketahui bahwa prevalensi infeksi bergantung pada letak geografis, iklim, karakteristik sosial, dan lingkungan. Indonesia masih menghadapi masalah berkaitan dengan peningkatan prevalensi dermatomikosis superfisial. Higiene pribadi buruk, kontak dengan sumber infeksi, status gizi, ketersediaan air bersih, dan suasana panas serta lembab merupakan beberapa faktor yang berperan. Secara umum, data dermatomikosis superfisial kebanyakan didapatkan dari rumah sakit di kota-kota besar. Data regional terutama di daerah pedalaman dalam upaya pengaturan strategi pelayanan kesehatan masih sangat sedikit. Pola jenis penyakit, karakteristik sosial, dan lingkungan yang berperan bisa ditemukan berbeda antar daerah di Indonesia, misalnya antara daerah perkotaan dan pesisir. Identifikasi pola jenis penyakit, berbagai karakteristik sosial, dan lingkungan penting untuk tatalaksana dermatomikosis superfisial lebih terarah dan menyeluruh. Tujuan: Untuk mengetahui karakteristik klinis, sosial, dan lingkungan pasien dermatomikosis superfisial di Kabupaten Raja Ampat, Papua Barat (kelompok Papua Barat) dan Divisi Mikologi Poliklinik Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta (kelompok Jakarta). Metode: Penelitian deskriptif dengan studi potong lintang dilakukan pada 55 SP dengan dermatomikosis superfisial di antara 150 pasien dermatosis di Kabupaten Raja Ampat, Papua Barat, dan 58 pasien dermatomikosis superfisial di Jakarta setelah penyetaraan dengan sejumlah proporsi jenis dermatomikosis superfisial yang diperoleh di Papua Barat. Hasil: Proporsi dermatomikosis superfisial di antara dermatosis di Kabupaten Raja Ampat, Papua Barat adalah 39,1%, terdiri atas 55,93% dermatofitosis dan 44,06% pitiriasis versikolor. Ditemukan sebanyak 36,4% tinea imbrikata di antara dermatofitosis pada SP di Papua Barat dan tidak ditemukan kasus tinea imbrikata pada SP di Jakarta. Dua jenis tinea non imbrikata terbanyak yang ditemukan baik pada SP di Papua Barat maupun Jakarta adalah tinea kruris dan korporis. Tinea fasialis ditemukan terbanyak ketiga di antara tinea non imbrikata di Papua Barat dan tidak ditemukan di Jakarta, sedangkan tinea pedis ditemukan terbanyak ketiga di antara tinea non imbrikata di Jakarta dan tidak ditemukan di Papua Barat. Sebagian besar kasus tinea kruris dan korporis memberikan gambaran klinis tipikal, baik di Papua Barat maupun Jakarta. Lokasi lesi pitiriasis versikolor terbanyak yang ditemukan adalah badan, baik di Papua Barat maupun Jakarta. Lokasi lesi pitiriasis versikolor di wajah lebih banyak ditemukan pada SP di Papua Barat. Lokasi lesi pitiriasis versikolor di lengan lebih banyak ditemukan pada SP di Jakarta. Baik di Papua Barat dan Jakarta, sebagian besar kasus pitiriasis versikolor memberikan gambaran klinis tipikal. Perbedaan karakteristik sosial dan lingkungan dermatomikosis superfisial yang didapatkan di Papua Barat dan Jakarta adalah SP di Papua Barat dengan dermatofitosis memiliki kecenderungan perawatan higiene pribadi yang lebih buruk dibandingkan dengan di Jakarta. Risiko kontak dengan sumber infeksi pada manusia cenderung lebih besar pada SP dengan dermatofitosis di Papua Barat dibandingkan dengan SP di Jakarta. Kontak dengan hewan dan tanah/tanaman lebih banyak pada SP dengan dermatofitosis di Papua Barat dibandingkan dengan SP di Jakarta. Akses mendapatkan air bersih cenderung lebih sulit pada SP dengan dermatofitosis dan pitiriasis versikolor di Papua Barat dibandingkan dengan SP di Jakarta. Faktor suasana panas dan lembab lebih banyak ditemukan pada SP dengan dermatofitosis di Papua Barat. Simpulan: Karakteristik klinis, sosial, dan lingkungan dermatomikosis superfisial ditemukan berbeda antara Kabupaten Raja Ampat, Papua Barat dan Jakarta.
Kata kunci: dermatomikosis superfisial, karakteristik klinis, karakteristik sosial, karakteristik lingkungan, dermatofitosis, pitiriasis versikolor, tinea imbrikata, Raja Ampat, Jakarta.


Background: Superficial dermatomycoses is fungal infections limited to the epidermis, hair, nails, and the mucous membrane. The three most common types of these infections are caused by dermatophyte fungus, Malassezia sp., and Candida sp., while the least common are tinea nigra, piedra, and the infections caused by non dermatophytic moulds. It is well observed that the prevalence of infections depends on geographic location, climate, various social, and environmental characteristics. Indonesia is still facing the problem associated with the increasing prevalence of superficial dermatomycoses. Poor personal hygiene, contact with the source of infection, nutritional status, availability of clean water, hot, and humid atmosphere are several factors that play a role. In general, data of superficial dermatomycoses in Indonesia were based on urban hospital reports. Regional data, especially in rural areas in an effort to setting health care strategy is still very scarce. The pattern of diseases, social, and environmental characteristics could be found different between regions in Indonesia, for example between urban and coastal areas. Identification pattern of diseases, social, and environmental characteristics is important for more focused and comprehensive superficial dermatomycoses management. Aim: To identify clinical, social, and environmental characteristics of superficial dermatomycoses in Raja Ampat District, West Papua (West Papua group) and Dermatology and Venereology Out Patient Clinic of Mycology Division Dr. Cipto Mangunkusumo National General Hospital Jakarta (Jakarta group). Methods: Descriptive study with a cross-sectional design was performed on 55 subjects with superficial dermatomycoses among 150 patients with dermatoses in West Papua, and 58 subjects with superficial dermatomycoses in Jakarta after matching with proportions of superficial dermatomycoses types obtained in West Papua. Results: The proportion of superficial dermatomycoses among dermatoses in Raja Ampat District, West Papua was 39,1%, comprising 55,93% dermatophytoses and 44,06% pityriasis versicolor. As many as 36,4% tinea imbricata was found among 44,06% pityriasis versicolor. As many as 36,4% tinea imbricata was found among dermatophytoses on the subjects in West Papua and no cases of tinea imbricata was found in Jakarta. Two most common types of tinea non imbricata found either on subjects in West Papua and Jakarta were tinea cruris and corporis, respectively. Tinea facialis was the third most common types among tinea non imbricata in West Papua but was not found in Jakarta, while tinea pedis was the third most common types among tinea non imbricata in Jakarta but was not found in West Papua. Most cases of tinea cruris and corporis had typical clinical manifestations, both in West Papua and Jakarta. Location of pityriasis versicolor lesions was found mostly on trunk, both in West Papua and Jakarta. Subjects with pityriasis versicolor in West Papua had a tendency to got lesions on the face, while subjects in Jakarta had a tendency to got lesions on the arms. Both West Papua and Jakarta, most cases of pityriasis versicolor had typical clinical manifestations. Regarding with the differences of social and environmental characteristics of superficial dermatomycoses obtained in West Papua and Jakarta, subjects with dermatophytoses in West Papua tend to had worse personal hygiene care than subjects in Jakarta. Risk of contact with the source of infection in humans tend to be larger in the subjects with dermatophytoses in West Papua as compared with subjects in Jakarta. Contact with animals and soil/plant was found more common in the subjects with dermatophytoses in West Papua rather than in the subjects in Jakarta. Access to clean water tend to be more difficult in the subjects with dermatophytoses and pityriasis versicolor in West Papua as compared with the subjects in Jakarta. Hot and humid atmosphere factors were more common in subjects with dermatophytoses in West Papua. Conclusion: Clinical, social, and environmental characteristics of superficial dermatomycoses were different between Raja Ampat District, West Papu and Jakarta.
Key words: superficial dermatomycoses, clinical characteristics, social characteristics, environmental characteristics, dermatophytoses, pityriasis versicolor, tinea imbricata, Raja Ampat, Jakarta.