Petticoat cancer: Marjolin ulcer of the waist in South Asian women (a site-specific malignancy)

A saree is a garment worn by women in the Indian subcontinent. It is 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. 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.