Prolonged Kangri Use Linked to Aggressive Skin Cancer in Kashmir

By Amara Osei

A 2009 study led by Dr Mohmad Ashraf Teli reported that Kangri cancer can spread to nearby lymph nodes and surrounding regions in 30% to 50% of cases. Kangri cancer is squamous cell carcinoma (SCC) associated in the report with repeated, direct heat exposure from a kangri, the winter heat source held close to the body in Kashmir.

The account does not state the number of cases, the exposed cohort, the study design, or the follow-up period for the 2009 report. The percentage therefore describes spread among the reported cases and cannot serve as a population-wide estimate of new cancer cases among kangri users.

What does prolonged exposure cause?

Doctors from SMHS Hospital and Government Medical College Srinagar, led by Dr Iffat Hassan, published studies in the Indian Journal of Dermatology concerning prolonged kangri use in Kashmir. Their reports identify erythema ab igne, a heat-associated pigmentary condition marked by dark brown or black pigmentation arranged in a net-like pattern.

The lower abdomen and inner thighs are among the most commonly affected areas because users often keep a kangri in close contact with the body for five to six hours daily during winter. The source does not publish the Hassan-led studies’ dates, sample sizes, diagnostic criteria, or follow-up, which limits assessment of how often observed pigmentation progressed.

How does heat-related damage progress?

The reports identify prolonged heat exposure as the principal cause of skin damage. Wood ash, smoke, and other substances released by burning chinar leaves may further aggravate the injury, but the account does not quantify the contribution of each exposure.

If the pigmentary condition remains untreated, doctors said it may progress to Bowen disease, a pre-cancerous form of SCC, and in some cases to invasive SCC, commonly called Kangri cancer in Kashmir. The source presents a progression sequence rather than a measured conversion rate, because it gives no denominator showing how many people with erythema ab igne developed cancer.

How concerning is the reported spread?

The Teli team characterized Kangri cancer as aggressive in its 2009 report, citing spread to nearby lymph nodes and surrounding regions in 30% to 50% of cases. The figure comes from cases already identified as Kangri cancer, not from a survey of all users with a skin mark.

The source does not say whether nodal or regional spread was present at diagnosis or arose during follow-up. It also supplies no tumor-size, depth, or disease-stage details, so the result cannot establish the prognosis for an individual lesion.

How old is the condition?

Clinical recognition of Kangri cancer is longstanding. Dr William Jackson Elmslie first documented it in 1866, and Dr Theodore Maxwell later reported it in 1879.

Those accounts establish historical recognition of Kangri cancer but do not establish current incidence, survival, or the size of the exposed population. The Nov. 3 dispatch from Srinagar also omits the year, preventing firm placement of the warning within the medical literature.

What should residents do?

The source’s practical recommendations are direct. They combine exposure reduction with attention to possible warning signs:

• Avoid direct contact between the kangri and the skin.
• Use a protective cloth barrier between the heat source and the body.
• Limit exposure to heat.
• Seek medical advice for persistent skin marks, itching, unusual growths, or non-healing lesions.

The barrier and exposure-reduction advice target prevention; the symptom advice supports evaluation of an existing lesion. The source offers no treatment protocol, screening interval, or biopsy criteria, while the practice of holding a kangri against the body for five to six hours each day makes reduced direct contact the clearest preventive message.

What would strengthen the evidence?

The news account leaves key denominators and methods outside the report. For the 2009 spread estimate and the later erythema ab igne observations, clinicians need documented exposed cohorts, lesion duration, diagnostic and staging criteria, treatment, and follow-up.

Before those gaps are filled, the 30% to 50% figure should be treated as a historical study finding rather than a precise forecast for each exposed person. Prospective cohort follow-up would test whether heat duration predicts progression and whether the historical spread estimate persists in contemporary Kashmir.