Sari cancer is a rare form of

skin cancer Skin cancers are cancers that arise from the Human skin, skin. They are due to the development of abnormal cells (biology), cells that have the ability to invade or metastasis, spread to other parts of the body. It occurs when skin cells grow ...

that occurs along the

waist The waist is the part of the Human abdomen, abdomen between the rib cage and Hip (anatomy), hips. Normally, it is the narrowest part of the torso. ''Waistline'' refers to the horizontal line where the waist is narrowest, or to the general appe ...

line in females wearing the

sari A sari (also called sharee, saree or sadi)The name of the garment in various regional languages include: * * * * * * * * * * * * * * is a drape (cloth) and a women's garment in the Indian subcontinent. It consists of an un-sti ...

, caused by constant irritation which can result in scaling and changes in pigmentation of the skin. It is a rare type of cancer and have been found in the

Indian subcontinent The Indian subcontinent is a physiographic region of Asia below the Himalayas which projects into the Indian Ocean between the Bay of Bengal to the east and the Arabian Sea to the west. It is now divided between Bangladesh, India, and Pakista ...

, where saris are commonly worn by girls and women throughout their lives. Although, it has more to do with hygiene and not taking care of one's skin. It involves

chronic inflammation Chronic systemic inflammation is the result of release of pro-inflammatory cytokines from immune-related cells and the chronic activation of the innate immune system. It can contribute to the development or progression of certain conditions such ...

Signs and symptoms

The foremost symptoms of sari cancer are the constant irritation with scaling and pigmentation change at the waistline; gradually, over the course of many years, these become chronic. The person may have non-healing

ulcer An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughin ...

or a hyper- or hypopigmented patch or a growth-like lesion over the waistline. The lesion may be associated with

serous In physiology, serous fluid or serosal fluid (originating from the Medieval Latin word ''serosus'', from Latin ''serum'') is any of various body fluids resembling serum, that are typically pale yellow or transparent and of a benign nature. The fl ...

discharge with foul smell.

Cause

The

is common female attire in the Indian subcontinent. It is a piece of long (generally ) cloth which can be made of various materials:

cotton Cotton (), first recorded in ancient India, is a soft, fluffy staple fiber that grows in a boll, or protective case, around the seeds of the cotton plants of the genus '' Gossypium'' in the mallow family Malvaceae. The fiber is almost pure ...

silk Silk is a natural fiber, natural protein fiber, some forms of which can be weaving, woven into textiles. The protein fiber of silk is composed mainly of fibroin and is most commonly produced by certain insect larvae to form cocoon (silk), c ...

nylon Nylon is a family of synthetic polymers characterised by amide linkages, typically connecting aliphatic or Polyamide#Classification, semi-aromatic groups. Nylons are generally brownish in color and can possess a soft texture, with some varieti ...

, chiffon or

synthetic fabric Synthetic may refer to: Science * Synthetic biology * Synthetic chemical or compound, produced by the process of chemical synthesis * Synthetic elements, chemical elements that are not naturally found on Earth and therefore have to be created in ...

. It is worn over an inner skirt (petticoat) which is tightened around the waist by a thick cotton cord. This is the traditional costume of most Indian women. The sari is attached to the waist throughout the day in the hot and humid climate. The waist is often soiled with dust and sweat and remains without proper cleaning. This causes changes in pigmentation and mild scaling over the waist. This, in turn, causes chronic irritation and gradually

malignancy Malignancy () is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous ''benign'' tumor in that a malignancy is not ...

may develop in the skin at the waistline.

Management

Excision biopsy is required to confirm the diagnosis of sari cancer. In many cases local excision with

skin grafting Skin grafting, a type of graft surgery, involves the transplantation of skin without a defined circulation. The transplanted tissue is called a skin graft. Surgeons may use skin grafting to treat: * extensive wounding or trauma * burns * ...

is considered the appropriate treatment. Different ways of wearing the petticoat may help sari-wearers to prevent sari cancer. Some such strategies are: * Loosening the petticoat * Changing the usual rope-like belt to broader ones that reduce pressure on the area * Continuously changing the level at which the petticoat is tied

History

In 1945 physicians Khanolkar and Suryabai described a new type of skin cancer with hypopigmented and thickened scars which were more likely to progress into malignant lesions. They termed it "dhoti cancer", the

dhoti The dhoti is an ankle-length breechcloth, wrapped around the waist and the legs, in resemblance to the shape of trousers. The dhoti is a garment of ethnic wear for men in the Indian subcontinent. The dhoti is fashioned out of a rectangular p ...

being a traditional male costume of India which like the sari is wrapped around the waist. The term "sari cancer" was first used by a group of doctors led by Dr. A. S. Patil from Bombay Hospital, India, in the ''Bombay Hospital Journal''. The dermatological problem in the waist of Indian women wearing saris had been recognised before by some other researchers. This type of cancer is related to

Marjolin's ulcer Marjolin's ulcer refers to an aggressive Ulcer (dermatology), ulcerating squamous cell carcinoma presenting in an area of previously Physical trauma, traumatized, chronically inflamed, or scarred skin.Freedberg, et al. (2003). ''Fitzpatrick's Derma ...

, the malignant degeneration of a chronic wound which was described by

Jean-Nicolas Marjolin Jean-Nicolas Marjolin (6 December 1780 – 4 March 1850) was a French surgeon and pathologist born in Ray-sur-Saône, Haute-Saône. His name is associated with a malady known as Marjolin's ulcer. After a brief stint in the French military, he att ...

in 1828.

References

{{Reflist

External links

Dhoti cancer: a waistline skin cancer with review of literature
Integumentary neoplasia Saris