Introduction:

Precocious puberty (PP) is characterized by the development of secondary sexual characteristics prematurely. There are different causes of PP. The objective of this article is to describe how inadvertent testosterone exposure can cause peripheral PP.

Clinical case:

Five-year-old male with macrogenitosomia and increased growth rate (20 cm/year). Physical examination: height 135 cm (80th percentile), facial acne, and increased muscle development; in genitalia, pubarche grade II, penis length 12 cm (Tanner 5), testicles 4 cm3 (Tanner 2). Bone age of 8.5 years. In laboratory studies, it was highlighted that serum testosterone levels were 98 ng/dL (normal < 5 ng/dL). In directed questioning, the father refers to the use of gel containing testosterone for aesthetic purposes, and close contact with his children. With all this information, diagnosis of peripheral PP was concluded. The gel was suspended, observing a decrease in testosterone to 60 ng/dL at 10 days.

Conclusion:

Testosterone-containing products used topically by parents can cause peripheral PP in children, which is characterized by virilization, with growth of external genitalia and accelerated skeletal maturation.

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