[Disorders of puberty and gonadal disorders in the child]

Normal puberty has a characteristic harmony or consonance between the individual modalities of sexual maturation. Thus, the objective description and detailed knowledge of physical pubertal development is the basis of the clinical analysis of pubertal disorders. An aim of the review is to provide details of the visible changes the clinician must note in order to document the normal progression of puberty. Disorders of puberty can be classified by the timing of onset of sexual characteristics into either precocious or delayed puberty. A more useful concept, however, than the abnormalities of timing of puberty is whether the pubertal development is true (consonant) or if there is a pseudo-puberty (absence of consonance). This is of greater significance in relation to the pathophysiology and, therefore, the investigations and therapies which will be required. The use of either well known or new agents that may be used for treatment of pubertal disorders are presented.