Premature Pubarche due to Exogenous Testosterone Gel or Intense Diaper Rash Prevention Cream Use: A Case Series
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Citações na Scopus
10
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
KARGER
Autores
MACEDO, Delanie Bulcao
NASCIMENTO, Marilza Leal
Citação
HORMONE RESEARCH IN PAEDIATRICS, v.91, n.6, p.411-415, 2019
Resumo
Background/Aims: Premature pubarche is associated with conditions such as virilizing congenital adrenal hyperplasia, androgen-secreting tumors, and exogenous exposure to androgen products. We describe the clinical and hormonal features of a series of children who were referred to endocrine evaluation due to premature pubarche. Methods: This is a retrospective case series study of 14 children with premature pubarche and/or virilization. Five were unintentionally exposed to testosterone gel (parental use). Nine patients were intensely exposed to diaper rash prevention creams. Clinical and laboratory data were revised. Results: Moderate to severe virilization was detected in the 5 patients (2 boys and 3 girls) who were exposed to testosterone gel. These patients had pubic hair development associated with clitoromegaly (3/3), penile enlargement (2/2), and accelerated growth (5/5). Testosterone levels were elevated in 4/5 patients associated with normal prepubertal gonadotropin levels and adrenal androgen precursors. The 9 children who were intensely exposed to diaper rash prevention creams had mild pubarche (intermediate hair) without any other clinical manifestation of pubertal development. Three of them exhibited pubic hair thinning after cream withdrawal. Conclusion: Unintentional topical androgen exposure or the intense use of diaper rash prevention cream should be ruled out in children with precocious pubarche and/or virilization signs to avoid misdiagnosis and expendable investigation.
Palavras-chave
Pubarche, Premature pubarche, Testosterone gel, Diaper rash prevention cream, Androgens
Referências
- Berger RS, 2003, BRIT J DERMATOL, V149, P354, DOI 10.1046/j.1365-2133.2003.05435.x
- Brucker Mary, 2015, Nurs Womens Health, V19, P422, DOI 10.1111/1751-486X.12233
- Carel JC, 2008, NEW ENGL J MED, V358, P2366, DOI 10.1056/NEJMcp0800459
- Martinez-Pajares JD, 2012, J PEDIATR ENDOCR MET, V25, P1007, DOI 10.1515/jpem-2012-0124
- de Ronde W, 2009, HUM REPROD, V24, P425, DOI 10.1093/humrep/den372
- Flor-Cisneros A, 2004, J CLIN ENDOCR METAB, V89, P236, DOI 10.1210/jc.2002-021954
- Franklin SL, 2003, J PEDIATR ENDOCR MET, V16, P107
- Fuqua JS, 2013, J CLIN ENDOCR METAB, V98, P2198, DOI 10.1210/jc.2013-1024
- Ge W, 2017, NANOTOXICOLOGY, V11, P465, DOI 10.1080/17435390.2017.1310947
- Green AL, 2014, PEDIATRICS, V133, pE1772, DOI 10.1542/peds.2013-1454
- Greulich WW, 1959, RADIOGRAPHIC ATLAS S, DOI [10.1097/00000441-195909000-00030, DOI 10.1097/00000441-195909000-00030]
- HermanGiddens ME, 1997, PEDIATRICS, V99, P505, DOI 10.1542/peds.99.4.505
- Kunz GJ, 2004, PEDIATRICS, V114, P282, DOI 10.1542/peds.114.1.282
- Latronico AC, 2016, LANCET DIABETES ENDO, V4, P265, DOI 10.1016/S2213-8587(15)00380-0
- Melnik BC, 2009, CURR OPIN ENDOCRINOL, V16, P218, DOI 10.1097/MED.0b013e32832afdfe
- Nelson D, 2013, J PEDIATR ENDOCR MET, V26, P981, DOI 10.1515/jpem-2013-0127
- Nicolopoulou-Stamati P, 2015, REV ENDOCR METAB DIS, V16, P373, DOI 10.1007/s11154-016-9329-4
- Park H, 2009, ANN DERMATOL, V21, P142, DOI 10.5021/ad.2009.21.2.142
- Salgueiro MJ, 2002, NUTRITION, V18, P510, DOI 10.1016/S0899-9007(01)00812-7
- Sharquie KE, 2012, J CLIN EXP DERMATOL, V3, P2
- Thompson JM, 2017, AM J CLIN DERMATOL, V18, P663, DOI 10.1007/s40257-017-0285-x
- Traish AM, 2011, AM J MED, V124, P578, DOI 10.1016/j.amjmed.2010.12.027
- Utriainen P, 2015, HORM RES PAEDIAT, V83, P221, DOI 10.1159/000369458
- Voelker R, 2009, JAMA-J AM MED ASSOC, V301, P2428, DOI 10.1001/jama.2009.810