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Testosterone/zinc-oxide Premature Pubarche and virilisation: 14 case reports In a retrospective study of 14 patients (9 girls and 5 boys) aged 0.3–6.8 years were described, who developed only premature pubarche (9 patients), premature pubarche with clitoromegaly (3 patients) or premature pubarche with penile enlargement (2 patients) during treatment with zinc-oxide for diaper rash prevention or an inadvertent exposure to testosterone [not all routes stated; dosages and time to reactions onsets not stated]. Five of the 14 patients were exposed to testosterone gel due to parental use (2 fathers and 2 mothers were on testosterone gel replacement for bodybuilding, and one father for the treatment of depression). These 5 patients developed severe premature pubarche (One girl had Tanner 3 stages curled and darker hair and rest had Tanner 2 stage pubic hair). Additionally, these patients developed penile enlargement (2 patients) and clitoromegaly (3 patients). Four of these 5 patients exhibited elevated testosterone levels on presentation (44–685 ng/dL). The testosterone levels normalised after parental testosterone use was stopped. This resulted in improvement of the condition in all the 5 patients. The other 9 patients, who were exposed to zinc-oxide in the form of diaper rash prevention creams, developed mild pubarche (intermediate hair). Three patients showed subsequent reduction of the pubic hairs due to stopping the usage of the diaper cream. Remaining 6 patients exhibited no progression of the pubic hair growth due to less frequent usage of the diaper cream. Author comment: "The iatrogenic exposure to exogenous androgen-containing topical products was suspected in these children due to the isolated increase of testosterone levels." "In this case series report, we describe the clinical and hormonal features of 14 children who were referred to endocrine evaluation due to premature pubarche." Ramos CDO, et al. Premature Pubarche due to Exogenous Testosterone Gel or Intense Diaper Rash Prevention Cream Use: A Case Series. Hormone Research in Paediatrics 91: 411-415, No. 6, Jan 2019. Available from: URL: http:// 803437262 doi.org/10.1159/000495664 - Brazil

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Reactions 30 Nov 2019 No. 1781