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How does 'petticoat' or'saree cancer' occur?

Image Credits: UnsplashImage Credits: Unsplash
  • Petticoat cancer is a rare but serious skin condition caused by chronic friction from tight waist cords in traditional Indian clothing.
  • Early detection and prevention are key, including avoiding tight petticoats, using broader waistbands, and maintaining good skin hygiene.
  • While primarily associated with sarees, similar risks exist with other tight-fitting traditional garments, highlighting the need for general awareness of clothing-related skin health.

[WORLD] In the vibrant tapestry of Indian culture, the saree stands as an iconic symbol of grace and tradition. However, a recent medical discovery has cast a shadow on this beloved garment, revealing an unexpected health risk known as 'petticoat cancer' or 'saree cancer'. This rare but significant condition has caught the attention of medical professionals and wearers alike, prompting a closer look at the intersection of cultural practices and health.

Petticoat cancer, also referred to as saree cancer or saree melanosis, is a dermatological condition that primarily affects women who wear sarees regularly. Dr. Darshana Rane, Consultant - Medical Oncology at HCG Cancer Centre, Borivali, explains, "A rare but notable condition called saree cancer can affect women who wear sarees daily. This unique condition usually occurs in the midsection, or at the waistline, and results from chronic irritation caused by a tightly tied petticoat cord (or nada), which secures the saree in place."

The condition is not limited to saree wearers alone. Similar skin conditions have been observed in women who predominantly wear churidars and men who wear dhotis, highlighting a broader concern with tight waistbands in traditional Indian attire.

The Science Behind Saree Cancer

The development of petticoat cancer is rooted in the chronic irritation and friction caused by tightly tied waist cords. When the petticoat or underskirt is fastened too tightly at the same level on the abdomen day after day, it can lead to a series of skin changes:

Initial Irritation: The constant pressure and rubbing cause dermatoses or skin irritation.

Progression to Ulcers: Over time, this irritation can develop into ulcers, specifically known as Marjolin's ulcers.

Malignant Transformation: In rare cases, these chronic ulcers can undergo malignant transformation, leading to squamous cell carcinoma.

The risk is exacerbated by environmental factors. Dr. Rane notes, "Irritation from the petticoat cord gets worse with the hot and humid climate of India, especially in rural areas where healthcare services are unavailable or not very accessible. Very often sweat and dust accumulate around the tightly tied cord causing itching and scratching."

Recognizing the Signs: Early Detection is Key

Awareness and early detection are crucial in managing the risk of petticoat cancer. The early signs of this condition include:

  • Hyperpigmentation or darkening of the skin around the waist
  • Skin thickening in the affected area
  • Formation of scaly, rough patches
  • Persistent itching or discomfort
  • Non-healing sores or ulcers

Dr. Rane emphasizes the importance of vigilance, especially for women in remote areas who may not have immediate access to healthcare. "Unfortunately, women who stay in remote areas may not pay attention to early symptoms such as pigmentation or mild scale signs and allow the condition to develop before seeking medical help," she warns.

Real-Life Cases: A Wake-Up Call

The BMJ Case Reports journal recently highlighted two cases that bring the reality of petticoat cancer into sharp focus:

A 70-year-old woman presented with pigmentation loss and a chronic ulcer on her right side. The tight waist cord had caused severe skin injury, resulting in a Marjolin ulcer that was later diagnosed as squamous cell cancer.

Another woman in her late 60s, wearing a traditional saree type called lugda, developed a similar ulcer that progressed to affect her lymph nodes.

These cases underscore the potential severity of the condition and the importance of early intervention.

Prevention: Balancing Tradition with Health

While the risk of petticoat cancer is concerning, it's important to note that it is preventable. Here are some key strategies to reduce the risk:

Avoid Tight Petticoats: Opt for looser fits, especially if you notice early signs of skin irritation.

Use Broader Waistbands: A wider waistband helps distribute pressure more evenly.

Rotate Tying Points: Change the waist level where you tie the petticoat regularly.

Prioritize Air Circulation: When at home, choose loose-fitting clothes with elastic waistbands.

Maintain Hygiene: Regularly clean the waist area, especially if you work outdoors.

Regular Skin Checks: Inspect your waist area frequently for any signs of irritation or changes.

Dr. Kamath, a medical expert, adds, "Consider using soft, breathable fabrics for petticoats and underskirts. Regularly moisturize the skin around the waist to maintain its health and elasticity."

Beyond Sarees: A Broader Perspective on Clothing-Related Skin Risks

While the focus has been on sarees and petticoats, it's crucial to understand that similar risks can arise from other tight-fitting traditional garments. Dr. Rane points out, "Similar skin conditions have also been noticed in women who predominantly wear churidars and men who wear dhotis. Though this is a rare condition, it points out the importance of awareness and preventive care."

This broader perspective highlights the need for a general awareness of how our clothing choices can impact skin health, regardless of the specific garment type.

The Role of Healthcare in Addressing Petticoat Cancer

The medical community plays a vital role in addressing the challenge of petticoat cancer. This includes:

Raising Awareness: Educating the public about the risks associated with tight waistbands and the importance of proper clothing practices.

Early Screening: Encouraging regular skin checks and promoting early medical consultation for any suspicious skin changes.

Research: Conducting further studies to understand the prevalence and risk factors associated with clothing-related skin cancers.

Treatment Advancements: Developing effective treatment protocols for early-stage squamous cell carcinomas resulting from chronic irritation.

Cultural Sensitivity in Health Communication

Addressing the issue of petticoat cancer requires a delicate balance between health advocacy and cultural sensitivity. The saree is not just a garment but a significant cultural symbol. Therefore, health messages need to be framed in a way that respects cultural practices while emphasizing the importance of safe wearing methods.

The discovery of petticoat cancer doesn't mean abandoning traditional attire. Instead, it calls for a thoughtful approach to how we wear these garments. By making small adjustments in how we wear sarees, petticoats, and other traditional clothing, we can significantly reduce the risk of developing this rare but serious condition.

Petticoat cancer, while rare, serves as a crucial reminder of the unexpected ways our daily habits can impact our health. By raising awareness, promoting early detection, and adopting simple preventive measures, we can continue to celebrate our cultural traditions while safeguarding our health.

As we move forward, it's essential to approach this issue with a balance of medical awareness and cultural respect. The goal is not to discourage the wearing of traditional attire but to empower individuals with the knowledge to wear them safely and comfortably.


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