Publication:

A precancerous saree lesion: a rare occurrence

Skin cancers are relatively uncommon malignancies; their incidence in India being less than 1% of all cancers. The incidence of malignancy in scar tissues is 0.1-2.5%. Squamous cell carcinoma of skin is second most common amelanotic malignancy next to basal cell carcinoma. The occurrence of this disease is noticed in various parts of the body but waist line skin is not a common site. Saree is a type of female costume and dhoti is a male costume which is unique to the Indian subcontinent. The persistent and long term wearing of this costume results in depigmentation and glazing of the skin, acanthosis, dysplasia, scar and ulceration and subsequent, but very slow, malignant changes. The exact mechanism of the malignant transformation is unknown, but recurrent trauma over a long period with consequent interference with the healing process is a possible explanation. We are presenting a rare case of left flank ulcero-proliferative growth in a 75 year old woman. Wide excision with primary skin closure was done. Histopathology showed pseudoepitheliomatous hyperplasia with marked dysplasia without microinvasion. It is a premalignant lesion. The case needs its reporting due to its rarity. Awareness of saree cancer among Indians is important to prevent malignant lesions at waistline. Multimodality management with surgery, chemotherapy and radiotherapy is ideal for good outcome.