Saree Cancer: a Rare Case
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CASE REPORT
Saree Cancer: a Rare Case Pranjal Rai 1 & Geeta Ghag 1 & Saurabh Sanjanwala 1 & Rishabh Jain 1 & Vipul Nandu 1 Received: 12 September 2019 / Accepted: 24 March 2020 # Indian Association of Surgical Oncology 2020
Abstract Skin cancers are rather uncommon malignancies comprising less than 1% of all the cancers in India. Drawstring dermatitis is a type of frictional dermatitis that can result from traditional tightly worn garments like “sari” and “salwaar-kameez”. The resulting chronic friction at the waist can lead to lichenified grooves, post inflammatory depigmentation/leukoderma and aggravating pre-existing dermatoses like vitiligo and lichen planus. Chronic friction combined with sweating and humid environment of the tropics predisposes to candida, dermatophytes and bacterial infections. Rarely, squamous cell carcinoma has been reported. Prevention of the condition lies in weight reduction and tying the drawstrings loosely, especially in those inclined to develop koebnerizing conditions. Saree cancer is a rare type of squamous cell carcinoma (SCC). Saree and dhoti are traditional male and female costumes, respectively, which is unique to the Indian subcontinent. Constant wear of this clothing tightly around the waist results in changes in pigmentation and scaling of the skin, acanthosis, scar and ulceration and subsequent, gradual malignant changes. The process of repeated trauma over a long time and consequent interference with the healing process may be the reason for malignant transformation. We are presenting a rare case of saree cancer in a 68-year-old woman, with distant ulceroproliferative growth in left loin, along the waistline, which showed well-differentiated SCC on biopsy. Wide excision with primary closure was done. Keywords Saree cancer . Skin cancer . Squamous cell carcinoma
Introduction Squamous cell carcinoma (SCC) is the second most common form of skin cancer after basal cell carcinoma. Risks for SCC include light-coloured skin, long-term sun exposure (UV rays), old age, exposure to certain chemicals, burns, old scars and some types of the human papilloma virus. Nauvari Saree is the Indian traditional female costume, which is her lifetime clothing. In 1945, Khanolkar and Suryabai described this cancer marked by hypopigmented and thickened scars which were more likely to progress into malignant lesion and termed it ‘dhoti cancer’ piece of cotton cloth worn to cover the lower part of the body in most parts of India [1]. The term ‘Saree Cancer’ was first used in the Bombay
* Vipul Nandu [email protected] 1
Department of General Surgery, HBT Medical College and Dr. R.N. Cooper Hospital, Mumbai, India
Hospital Journal by Dr. Patil et al. from Bombay Hospital, India, and created quite a furor in Indian media recently [2]. Saree cancer is analogous to Marjolin’s ulcer in aetiology, involving chronic inflammation. Saree cancer is a type of SCC of the skin that occurs along the waistline in females wearing saree perpetually. Continual wearing of the tightly bound saree causes pers
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