Dermatological signs in South Asian women induced by sari and petticoat drawstrings

Cutaneous Squamous Cell Cancer on the Waistline Associated with Saree-wearing: A Case Report and Literature Review

Abstract is missing Short communication

Current understanding of frictional dermatoses: A review

Human skin is continually exposed to internal and external forces, dynamic as well as static. The skin is normally flexible and can resist mechanical trauma due to friction, pressure, vibration, suction and laceration to a considerable degree. However, an excess of these forces can abnormally affect the structure and function of the skin, setting the stage for the development of a skin disorder. Repetitive trauma can cause lichenification, hyperpigmentation, erythema, scaling, fissuring, blisters, ulceration and chronic alterations. Frictional dermatoses is an under-recognised entity with no clear-cut definition and encompasses a variety of terms such as frictional dermatitis, frictional melanosis, frictional pigmentary dermatoses and certain other named entities, many of which are confusing. The authors propose to define frictional dermatoses as 'a group of disorders caused by repetitive trauma to the skin as a result of friction of varied aetiology which can have a wide range of cutaneous manifestations depending on the type of insult.' The exact prevalence of frictional dermatoses as a separate entity is unknown. Authors who conducted this review include a group of dermatologists and post graduate students from various institutions. Literature was reviewed through PubMed, Medscape, Medline, ResearchGate and Google Scholar using the terms 'frictional dermatitis,' 'friction and skin,' 'dermatoses and culture,' 'clothing dermatitis,' 'friction melanosis,' 'PPE induced dermatoses in COVID-19 era,' etc. A total of 122 articles were reviewed and 100 articles among them were shortlisted and included in the study, after removing duplications. The review was followed up with further deliberation which resulted in the formulation of a new definition and classification of frictional dermatoses taking into account the morphology, histopathological characteristics, anatomical region affected and the major predisposing factors. The rising incidence of mechanical dermatoses in the COVID-19 era was also emphasised.

Immunocompromised Districts of Skin: A Case Series and a Literature Review

BACKGROUND

The concept of immunocompromised districts of skin has been developed by Ruocco and helps to explain certain aspects of the macromorphology of skin diseases. This concept unites the isomorphic response of Koebner and the isotopic response of Wolf.

CASE REPORTS

We present different cutaneous conditions which can lead to immunocompromised districts of skin such as scars, radiodermatitis, lymphedema, disturbed innervation or mechanical friction etc. Typical and rarer skin disorders associated with them are discussed and illustrated by their observations.

CONCLUSION

At this moment, we wish to inform dermatologists and non-dermatologists about Ruocco's concept and its implications.

Frictional Dermatosis in a Courier Driver

Frictional hypermelanosis is an uncommon finding in Caucasians. We report the unusual case of 56-year-old male courier driver who developed linear and patchy hypermelanosis of the back caused by the driver’s seat. Histology has included other pathologies. Treatment of the asymptomatic hyper pigmentation was not warranted.

Drawstring lichen planus: A unique case of Koebnerization

Drawstring dermatitis is a type of frictional dermatitis that can result from a traditional tightly worn garments such as sari or salwaar-kameez. We report a 54-year-old female patient presented with lichen planus of the drawstring site that was confirmed histopathologically. This case is rare and demonstrates how sociocultural practices can influence the presentation of common dermatoses such as LP.

Dermatoses due to Indian cultural practices

A wide prevalence of socio-religious and cultural practices in the Asian subcontinent often leads to multitude of skin diseases which may be missed by the dermatologists because of a lack of awareness. ‘Henna’ use causes IgE-mediated hypersensitivity reactions and contact dermatitis. ‘Kumkum’ application can result in pigmented contact dermatitis and lichen planus pigmentosus. Sticker ‘bindis’ and ‘alta’ induce contact leukoderma. Irritant and allergic contact dermatitis occurs after playing with ‘Holi’ colors. Threading and drawstring dermatitis lead to koebnerization of pre-existing dermatoses, infections and even squamous cell carcinoma of skin. Mild irritant reactions and contact sensitization occur secondary to balm and hair oil use. ‘Mudichood’ represents the comedogenic effect of hair oils combined with occlusion and humidity. Aromatherapy oils can cause contact dermatitis and photosensitive reactions. Heavy metal and steroid toxicity along with severe cutaneous adverse effects like erythroderma can occur as a consequent to the use of alternative medicines. Squamous cell carcinoma due to chronic heat exposure from the heating device “kangri” is seen in Kashmiris. Prayer nodules in Muslims and traction alopecia in Sikhs illustrate how religious practices can negatively affect the skin. With increasing globalization and migration, the practice of indigenous customs and traditions is no longer limited to regional territories, making it imperative for the dermatologists to be acquainted with the cutaneous side effects they can cause.