A tightly tied waist cord of the underskirt (petticoat) traditionally worn under a saree, particularly in rural parts of India, may lead to what has been dubbed 'petticoat cancer,' warn doctors in the journal BMJ Case Reports after treating two women with this type of malignancy. The continued pressure and friction on the skin can cause chronic inflammation, leading to ulceration, and, in some cases, progression to skin cancer, say the authors. This phenomenon has previously been described as "saree cancer," but it is the tightness of the waist cord that's to blame, they point out.
The first case concerned a 70 year old woman who sought medical help because of a painful skin ulcer on her right flank that she had had for 18 months and which wouldn't heal. The skin in the surrounding area had lost its pigmentation. She wore her petticoat underneath her saree which was tightly tied around her waist.
A biopsy specimen revealed that she had a Marjolin ulcer, also known as squamous cell carcinoma (ulcerating skin cancer). The second case concerned a woman in her late 60s who had had an ulcer on her right flank that wouldn't heal for 2 years. She had worn a traditional type of saree called a 'lugda' every day for 40 years, tied very tightly around the waist without an underskirt.
A biopsy specimen revealed that she too had a Marjolin ulcer. The cancer had already spread to one of the lymph nodes in her groin when she was diagnosed. A Marjolin ulcer is rare but aggressive.
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