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Published on: August 28, 2013
Kinetics and effect of percutaneous administration of dihydrotestosterone in children
E Charmandari1, M T Dattani, L A Perry
1London Centre for Paediatric Endocrinology, University College London, London, UK. charmane@mail.nih.gov
Insights
Percutaneous dihydrotestosterone (DHT) gel effectively promotes phallic growth in children with micropenis. Doses of 0.2-0.3 mg/kg daily for 3-4 months achieved significant growth in patients with adequate masculinization or awaiting surgery.
Area of Science:
- Pediatric Endocrinology
- Andrology
- Dermatology
Background:
- Dihydrotestosterone (DHT) percutaneous administration aids phallic growth in 5 alpha-reductase deficiency.
- This study evaluates DHT efficacy for micropenis from other causes.
Purpose of the Study:
- To assess the effectiveness of percutaneous DHT gel in treating micropenis in children with various etiologies.
- To determine optimal dosage and duration for phallic growth induction.
Main Methods:
- Prospective study of six pediatric patients (1.9-8.3 years) with micropenis.
- Daily application of 2.5% DHT gel (0.15-0.33 mg/kg).
- Serum DHT levels monitored for 24 hours post-application.
Main Results:
- Peak serum DHT levels reached within 2-8 hours, generally within adult ranges.
- Phallic growth of 0.5-2.0 cm observed after 3-4 months in patients with adequate DHT levels.
- Lower dose (0.15 mg/kg) resulted in sub-therapeutic DHT levels.
Conclusions:
- Percutaneous DHT gel (0.2-0.3 mg/kg daily for 3-4 months) is a potential treatment for micropenis.
- Beneficial for patients with testosterone biosynthetic defects or pre-surgical candidates.
- Ensuring adequate DHT serum concentrations is crucial for therapeutic effect.
Background:
Percutaneous administration of dihydrotestosterone (DHT) has been successful in promoting phallic growth in infants and children with 5 alpha-reductase deficiency raised as males. We investigated whether percutaneous administration of DHT is similarly effective in patients with micropenis due to alternative diagnoses.
Methods:
Six patients (age range 1.9-8.3 years) with micropenis of variable etiology were studied prospectively. 2.5% DHT gel was applied to the phallus once daily at a dose of 0.15-0.33 mg/kg body weight. Serum DHT concentrations were measured at 0, 2, 4, 8, 12 and 24 h following application of DHT gel.
Results:
Peak DHT concentrations were attained within 2-8 h after application of the gel and subsequently remained within the normal adult range in all but 1 patient, who had received the lowest dose of 0.15 mg/kg. An increase in phallic growth, ranging from 0.5-2.0 cm, was achieved after 3-4 months of treatment in all patients whose DHT concentrations were maintained within adult range.
Conclusion:
Percutaneous administration of DHT in a dose of 0.2-0.3 mg/kg once daily for a period of 3-4 months may be useful in the management of patients with testosterone biosynthetic defects, who have sufficient masculinization to warrant male sex assignment, or in patients with micropenis prior to reconstructive surgery.
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