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Precocious puberty secondary to topical testosterone exposure.
Sherry Lynn Franklin1, Mitchell E Geffner
1Mattel Children's Hospital at UCLA, Los Angeles, CA, USA.
Journal of Pediatric Endocrinology & Metabolism : JPEM
|February 15, 2003
Summary
Accidental exposure to a father's topical testosterone cream caused significant virilization in a young boy. This included rapid physical development and hormonal changes due to prolonged contact.
Area of Science:
- Pediatric endocrinology
- Environmental health
Background:
- Topical testosterone creams are commonly prescribed for testosterone replacement therapy in adult males.
- Accidental exposure in children can occur through direct contact with the application site or contaminated surfaces.
Observation:
- A 2.67-year-old boy presented with signs of precocious puberty.
- Symptoms included accelerated linear growth, advanced bone age, increased muscle mass, and development of secondary sexual characteristics like pubic hair growth and phallic enlargement.
Findings:
- The child's symptoms were attributed to prolonged, inadvertent exposure to a topical testosterone cream used by his father.
- Hormonal analysis (though not detailed in the abstract) would be expected to show elevated testosterone levels consistent with virilization.
Implications:
- Highlights the critical need for safe storage and application of topical hormonal therapies in households with young children.
- Underscores the potential for endocrine disruption from environmental exposure to exogenous hormones.
- Emphasizes the importance of considering environmental exposures in the differential diagnosis of pediatric virilization.