Every women love wearing saree, a popular attire worn in the Indian subcontinent. Sarees are usually wrapped around the body and secured over an ankle-length skirt (a petticoat). The petticoat is usually tied very tightly around the waist with a cord.
Studies have shown that the tight petticoat can lead to skin disorders and even a rare form of cancer dubbed ‘petticoat cancer ’ or ‘saree cancer’. A 2024 study published in the BMJ Case Reports revealed that the tight cord of the petticoat often leads to dermatoses related to chronic friction and maceration, resulting in dermatitis and depigmentation. In rare cases, chronic friction may lead to the development of squamous cell carcinoma.
“In the literature, these skin lesions, including malignant transformation, have been described as ‘saree cancers’, but it is the tightness of the cord tied around the waist that results in chronic inflammation that may result in malignant transformation. We report two cases of squamous cell carcinoma in women associated with tight petticoat cord ties—‘petticoat’ cancer,” the journal stated.
What is ‘petticoat cancer’?
Petticoat cancer, also known as Marjolin’s ulcer, is a rare form of skin cancer that develops around the waistline in individuals who wear tightly tied saree underskirts (petticoats) or dhotis. According to experts, the constant friction and pressure from the tightly tied waist cords can lead to chronic skin irritation, pigmentation, and ulceration, which can eventually progress to squamous cell carcinoma.
A Marjolin ulcer is rare but aggressive. It develops in chronic burn wounds, non-healing wounds, leg ulcers, tuberculous skin nodules, and in vaccination and snake bite scars, explain the authors.
What are the symptoms of ‘petticoat cancer’?
According to the researchers, in India’s hot and humid climate, particularly in rural regions, this condition can worsen rapidly. Some of the symptoms of ‘petticoat cancer’ include:
Early Signs
Marjolin ulcer early symptoms can be subtle, making early diagnosis challenging. Some initial signs to watch for include:
- A persistent non-healing wound
- Changes in the color or texture of a scar
- Itching or pain in a scar or chronic wound
- Development of a mass or nodule
Advanced Symptoms
As the ulcer progresses, more noticeable symptoms may appear, such as:
- A foul-smelling discharge
- Ulceration with raised, rolled edges
- Rapid increase in size
- Bleeding and crusting
How ‘petticoat cancer’ is treated?
According to experts, early diagnosis and prompt medical attention is crucial, as early-stage detection of squamous cell carcinoma significantly improves treatment outcomes.
How ‘petticoat cancer’ is prevented?
The authors of the study published in the BMJ Case Reports recommended wearing a loose petticoat beneath the saree to ease pressure on the skin, and to wear loose clothing if skin problems develop to allow the area to heal. Here are steps individuals can take to prevent this rare condition:
- Avoid Tightly Tied Cords: Refrain from tying saree, dhoti, or salwar cords too tightly around the waist. Instead, opt for looser, adjustable waistbands that reduce pressure on the skin.
- Wear Comfortable Fabrics: Choose soft, breathable materials that minimize friction and moisture buildup. Cotton or lightweight, natural fabrics are recommended to allow the skin to breathe.
- Regular Skin Checks: Inspect your waistline regularly for any unusual changes, particularly for persistent lesions or irritation.
- Practice Good Hygiene: Clean and moisturise the skin regularly to reduce the risk of inflammation and friction-related damage.
- Seek Professional Help for Persistent Issues: If any skin irritation, wound, or lesion doesn’t heal over time, consult a dermatologist or oncologist for an assessment.