Diseases in Kashmir

Kangri Cancer as name highlights is a type of cancer most prevalent in the Kashmir valley.
Kangri Cancer is a type of Squamous.

Cell Carcinona of the Skin.
In the current Scenario the caution of Cancer is being so vigorously investigated. Meanwhile, the etiology of many forms of magligant diseases is involved in profound obscurity.
The Kangri Cancer is sharply defined type of Squamous Cell Carcinoma.
Causes: The essential cause of disease is Kangri.
The constant irritation by intense heat from the Kangri being held against the body.
The first affect of intense heat is the dermitis, and then there is the proliferation of epithelium.
Heat is the prime factor, while is produced by consuming wood, coal in the Kangri.
The Kangri burn cancer is the expose of skin to simple heat also temperature experimentally founded was above 150o & 200oF.
Prevalence : their slightly male prediction average age affected is 55%.
About 6-7% cases are over 70 years of age.
Predisposing Factors
Patients exhibiting small localized.
Papules or macules.
Dry, Slightly scaly & usually pigmented.
Curiously these are not found on heat exposed areas but extensor areas and bact.

Is Heat Irritation Stimulatory Factor for Epithelial Growth?

Yes, where there is actual expose to heat rays every stage of chronic dermatitis may be seen. There is a redness with or without desquamation to thickened patches, warty in duration.
The skin of thighs & abdomen owing to constant heat irritation appears dry pigmentation is increased over the superficial veins distribution.
Evidence: The evidence of Kangri concern is indeed strongly against the parasitic theory of Cancer. It is disease : locally present with local cause.

What is the Mechanism

As the incidences are more prone in the elderly people, it is suggestive of probable relation to impaired functions of growth and repair and unstable equilibrium of endocrines.
Early Stages: Warty, Keratin, thickening may be present without erosion, but more commonly there is an ulcer.
There is a type of fungation.
Eroded Type: Eroded type is more prevalent in aged people.
Ulceration with irregular edges, undermined in some places & ragged floor and neurotic areas.
In some cases there is a projection of two or three inches diameter approx oval or circular with crater libe ulcer.
Advances Cases: Muscular peritoneum, costal cartilages or even bone may be involved.
More than 50% of cases when studied showed secondary involvement of lymph nodes.
As the tumour is mostly on thigh & abdomen the glands of Scarpa’s triangle and along Poupast’s ligament.
The infected glands attain size of pigeon’s egg.

Diagnosis

Biopsy: two Types
Incisional Biopsy
Punch Biopsy

Histologic Feature

Kangri Burns Cancer on Cross Section
Slites method for demonstrating epithelial neoplastic inflatration ; on examination tissue shows:
Fibrous tissues
Mottled Real and Grey
Wooly Patches
Cholesterin Crystals
Abundant Cell Nests
Keratin Pearls
Hyperkeratosis. Hyperplasia

Treatment

Very Small Skin Cancer
Curettage & Electrodessication.
Laser Therapy.
Freezing.
Photo Dynamic Therapy.
Large Size Cancer:
Simple Excision.
Mohs Surgery.
Radiation Therapy.

For cancers that spreads beyond skin
Chemo Therapy
Targeted Drug Therapy
Immune Therapy

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