Saree Cancer: a Rare Case

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

“…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 – 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.…”

“…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 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 ).…”