Saree Cancer: a Rare Case

Cutaneous Squamous Cell Cancer on the Waistline Associated with Saree-wearing: A Case Report and Literature Review

“…Furthermore there is 1 case of bilateral waistline cSCC ( 4 ). In 4 cases reactive inguinal lymphadenopathy was described ( 2 , 4 , 8 , 12 ). In 2 cases nodal metastases were identified, 1 case was identified on inguinal block node dissection and no follow-up data is available, in the other case patient underwent chemotherapy with paclitaxel and carboplatin followed by surgical resection and chemotherapy and maintained remission at the time of report 2 years after treatment ( 7 , 10 ).…”

“…Saree and dhoti cancers were first described in India in 1945 as waistline cSCCs appearing within friction lines corresponding with waistline drawstrings (1). At least 11 further cases of saree/dhoti cancer have been published since then (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Overall, 72% are reported in females, the median duration of saree/dhoti use before cSCC development is 50 years, the median diameter of cSCCs at the time of excision was 7 cm and, in 4 cases, other skin changes were noted, particularly involving the contralateral waistline skin and most commonly described as hypopigmentation and scaling, as in the current case.…”

“…“Saree cancers” and “dhoti cancers” are rare forms of cutaneous squamous cell carcinoma (cSCC), named so for developing on the waistline of people wearing traditional South Asian clothing that requires a tight cotton cord drawstring around the waist; namely, sarees and dhotis ( 1 ). The resulting chronic pressure and friction can produce permanent secondary skin changes, including dyspigmentation, acanthosis, scaling, ulceration and scarring, known as saree/dhoti “lines” or “drawstring dermatitis” ( 2 ). Such clothing can also exacerbate pre-existing koebnerizing dermatoses, such as lichen planus and vitiligo ( 3 ).…”