Saree- and dhoti-induced waist dermatoses leading to squamous cell carcinoma: A systematic review

Saree and dhoti, the traditional attires worn by women and men, respectively, in the Indian subcontinent, have deep cultural significance. However, prolonged mechanical irritation from the tightly draped waistband can lead to chronic dermatoses, which, in rare cases, may progress to squamous cell carcinoma (SCC). This systematic review aims to evaluate the association between chronic saree- and dhoti-induced waist dermatoses and SCC by analyzing available case reports and studies. A comprehensive literature search was conducted, identifying 11 case reports and studies detailing the clinical progression, pathophysiology, diagnostic approaches, and management strategies of saree- and dhoti-induced SCC. Findings indicate that persistent frictional trauma at the waist leads to chronic inflammation, hyperkeratosis, and eventual malignant transformation in susceptible individuals. Delayed diagnosis and lack of awareness often contribute to advanced disease presentation. Early recognition of pre-malignant changes, along with appropriate histopathological evaluation, plays a crucial role in timely intervention. Surgical excision remains the primary treatment modality, with adjuvant therapies considered in advanced cases. Chronic mechanical irritation from saree waistbands poses a potential risk for SCC development. Increased awareness among healthcare providers and at-risk populations is essential for early detection and prevention. Adoption of preventive measures, including lifestyle modifications and periodic dermatological assessments, may help reduce the burden of saree- and dhoti-induced SCC.