Sari cancer is a type of

skin cancer Skin cancers are cancers that arise from the skin. They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body. There are three main types of skin cancers: basal-cell skin cancer (BCC) ...

that occurs along the

waist The waist is the part of the abdomen between the rib cage and hips. On people with slim bodies, the waist is the narrowest part of the torso. ''Waistline'' refers to the horizontal line where the waist is narrowest, or to the general appear ...

line in females wearing the

sari A sari (sometimes also saree or shari)The name of the garment in various regional languages include: * as, শাৰী, xārī, translit-std=ISO * bn, শাড়ি, śāṛi, translit-std=ISO * gu, સાડી, sāḍī, translit-std ...

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

Indian subcontinent The Indian subcontinent is a list of the physiographic regions of the world, physiographical region in United Nations geoscheme for Asia#Southern Asia, Southern Asia. It is situated on the Indian Plate, projecting southwards into the Indian O ...

, where saris are commonly worn by girls and women throughout their lives. It is similar to Marjolin's ulcer in cause, involving

chronic inflammation Chronic systemic inflammation (SI) 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 ...

Signs and symptoms

The foremost symptoms of sari cancer are the constant irritation with scaling and pigmentation change at the waistline; gradually 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 sloughing o ...

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 flu ...

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 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 cellulose, and can contain minor pe ...

silk Silk is a natural protein fiber, some forms of which can be woven into textiles. The protein fiber of silk is composed mainly of fibroin and is produced by certain insect larvae to form cocoons. The best-known silk is obtained from the ...

nylon Nylon is a generic designation for a family of synthetic polymers composed of polyamides ( repeating units linked by amide links).The polyamides may be aliphatic or semi-aromatic. Nylon is a silk-like thermoplastic, generally made from pe ...

, chiffon or synthetic fabric. 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. Malignancy is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous ''benign'' tumor in that a malignancy is not s ...

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. The transplanted tissue is called a skin graft. Surgeons may use skin grafting to treat: * extensive wounding or trauma * burns * areas of extensive skin loss d ...

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, also known as veshti, vetti, dhuti, mardani, chaadra, dhotar, jaiñboh, panchey, is a type of sarong, tied in a manner that outwardly resembles "loose trousers". It is a lower garment forming part of the ethnic costume for men in the ...

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, the malignant degeneration of a chronic wound which was described by Jean-Nicolas Marjolin in 1828.

References

{{Reflist

External links

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