New Delhi, Nov 6 (IANS): Love to wear sarees daily? Beware, draping it tightly may give you skin cancer, warned doctors in Bihar and Maharashtra on Wednesday.

After treating two women with this type of malignancy, doctors from Jawaharlal Nehru Medical College in Wardha, and Madhubani Medical College and Hospital, in Bihar warned that tightly tied waist cord of the underskirt (petticoat) traditionally worn under a saree, particularly in rural parts of India, may cause continued friction linked to chronic inflammation, leading to skin ulceration, and in some cases, progress to skin cancer.

The phenomenon has previously been described as “saree cancer,” but it is the tightness of the waist cord that’s to blame, the doctors pointed out in the study published in the BMJ Case Reports, and dubbed it as ‘petticoat cancer’.

In the first case, a 70-year-old woman sought medical help because of a painful skin ulcer on her right flank that she had had for 18 months and which wouldn’t heal. The skin in the surrounding area had lost its pigmentation. She wore her petticoat underneath her Nauvari saree which was tightly tied around her waist.

The doctors conducted a biopsy, which revealed that the woman had a Marjolin ulcer, also known as squamous cell carcinoma (ulcerating skin cancer).

Another woman in her late 60s consulted doctors for an ulcer on her right flank that wouldn’t heal for two years. For 40 long years, she has been wearing a traditional ‘lugda’ saree daily, which is tied very tightly around the waist without an underskirt.

A biopsy specimen revealed that she too had a Marjolin ulcer. The cancer had already spread to one of the lymph nodes in her groyne when she was diagnosed.

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, the doctors explained.

The doctors noted that while the exact mechanism by which chronic ulcers or wounds become malignant remains unknown, “every cutaneous lesion that is continuously irritated (chronically inflamed) has been shown to have a higher risk of developing malignant transformation.”

“Constant pressure at the waist often leads to cutaneous atrophy, which ultimately breaks down to form an erosion or an ulcer,” they added.

The experts said that this ulcer often “does not heal entirely due to ongoing pressure from tight clothing. A chronic non-healing wound results, which may develop malignant change”.

The health experts recommend 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.