Saree Cancer: a Rare Case

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.