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Benign Premature Thelarche

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1. Benign Premature Thelarche

Benign Premature Thelarche Benign Premature Thelarche Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Benign Premature Thelarche (...) Benign Premature Thelarche Aka: Benign Premature Thelarche , Premature Thelarche From Related Chapters II. Epidemiology Onset as early as age 18 months III. Pathophysiology Benign self-limited cause of IV. Exam Examine with girl lying down Identify if glandular tissue beneath areola V. Signs Early development (not to mature contour) Isolated glandular tissue on palpation No other signs of Normal prepubertal growth rate VI. Differential Diagnosis stia Fatty tissue in obese girls VII. Imaging

2018 FP Notebook

2. Benign Premature Thelarche

Benign Premature Thelarche Benign Premature Thelarche Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Benign Premature Thelarche (...) Benign Premature Thelarche Aka: Benign Premature Thelarche , Premature Thelarche From Related Chapters II. Epidemiology Onset as early as age 18 months III. Pathophysiology Benign self-limited cause of IV. Exam Examine with girl lying down Identify if glandular tissue beneath areola V. Signs Early development (not to mature contour) Isolated glandular tissue on palpation No other signs of Normal prepubertal growth rate VI. Differential Diagnosis stia Fatty tissue in obese girls VII. Imaging

2015 FP Notebook

3. Disorders of the Breast (Diagnosis)

thelarche Benign premature thelarche is defined as isolated breast development in females aged 6 months to 9 years. Physical examination for this entity should carefully seek out other signs of puberty, such as development of pubic hair, thickening of the vaginal mucosa, and accelerated bone growth. If no other signs of puberty are present, reassure the patient and family that this is a benign finding. Examine the child every 6-12 months. If other signs of puberty are evident, precocious puberty should (...) involves antibiotics, needle aspiration, or surgical drainage. The decision for surgical drainage should be carefully made because future breast deformation may occur. For this reason, needle aspiration is the preferred treatment. [ ] The literature suggests that drainage alone, without adjunctive antibiotics, may be effective in skin and soft-tissue abscesses caused by MRSA; no definitive antibiotic recommendation regarding MRSA breast abscesses in particular is recognized. [ ] Benign premature

2014 eMedicine Pediatrics

4. Psychosocial and Environmental Pregnancy Risks (Treatment)

. Premature thelarche and alterations in menstruation in humans are speculated to be associated with plant estrogens. Intervention Apart from the avoidance of accumulated DDT and the use of endocrine modulators early in pregnancy, few recommendations can be made definitively about endocrine disrupters. It would be reasonable to suggest that pregnant women avoid the use of certain products in which endocrine disturbers are found to be very prevalent, such as avoiding the excessive consumption of canned

2014 eMedicine.com

5. Psychosocial and Environmental Pregnancy Risks (Overview)

. Premature thelarche and alterations in menstruation in humans are speculated to be associated with plant estrogens. Intervention Apart from the avoidance of accumulated DDT and the use of endocrine modulators early in pregnancy, few recommendations can be made definitively about endocrine disrupters. It would be reasonable to suggest that pregnant women avoid the use of certain products in which endocrine disturbers are found to be very prevalent, such as avoiding the excessive consumption of canned

2014 eMedicine.com

6. Psychosocial and Environmental Pregnancy Risks (Follow-up)

. Premature thelarche and alterations in menstruation in humans are speculated to be associated with plant estrogens. Intervention Apart from the avoidance of accumulated DDT and the use of endocrine modulators early in pregnancy, few recommendations can be made definitively about endocrine disrupters. It would be reasonable to suggest that pregnant women avoid the use of certain products in which endocrine disturbers are found to be very prevalent, such as avoiding the excessive consumption of canned

2014 eMedicine.com

7. Precocious Puberty (Overview)

common, benign, normal variant conditions that can resemble precocious puberty but are nonprogressive or very slowly progressive. Premature thelarche refers to the isolated appearance of breast development, usually in girls younger than 3 years; premature pubarche refers to appearance of pubic hair without other signs of puberty in girls or boys younger than 7-8 years. A thorough history, physical examination, and growth curve review can help distinguish these normal variants from true sexual (...) of the normal distribution. Age If precocious puberty in females (mostly central) is defined as the early onset of breast development, then the data of Herman-Giddens et al can be used to estimate frequency of central precocious puberty at different ages in both white girls and black girls. Be cautious, however, in equating breast development in 3-year-olds with central precocious puberty because most such girls actually have premature thelarche, a benign normal variant (see Differentials). The younger

2014 eMedicine Pediatrics

8. Precocious Pseudopuberty (Overview)

or masculinizing. The most common tumor associated with isosexual precocity is the benign ovarian follicular cyst. The cells lining the cysts are luteinized, leading to estrogen production. Granulosa cell tumor is the next most common feminizing neoplasm of the ovary. Juvenile granulosa cell tumors that develop in premenarchal females produce sexual precocity as a consequence of estrogen secretion. This may present as premature breast development or vaginal bleeding. Virilization may also be present (...) , Miettinen PJ, Kariola L, Hietamäki J, Tarkkanen A, et al. Precocious Puberty or Premature Thelarche: Analysis of a Large Patient Series in a Single Tertiary Center with Special Emphasis on 6- to 8-Year-Old Girls. Front Endocrinol (Lausanne) . 2017. 8:213. . [Guideline] American Academy of Pediatrics: Committee on Psychosocial Aspects of Child and Family Health and Committee on Adolescence. American Academy of Pediatrics: Committee on Psychosocial Aspects of Child and Family Health and Committee

2014 eMedicine Pediatrics

9. Precocious Pseudopuberty (Diagnosis)

or masculinizing. The most common tumor associated with isosexual precocity is the benign ovarian follicular cyst. The cells lining the cysts are luteinized, leading to estrogen production. Granulosa cell tumor is the next most common feminizing neoplasm of the ovary. Juvenile granulosa cell tumors that develop in premenarchal females produce sexual precocity as a consequence of estrogen secretion. This may present as premature breast development or vaginal bleeding. Virilization may also be present (...) , Miettinen PJ, Kariola L, Hietamäki J, Tarkkanen A, et al. Precocious Puberty or Premature Thelarche: Analysis of a Large Patient Series in a Single Tertiary Center with Special Emphasis on 6- to 8-Year-Old Girls. Front Endocrinol (Lausanne) . 2017. 8:213. . [Guideline] American Academy of Pediatrics: Committee on Psychosocial Aspects of Child and Family Health and Committee on Adolescence. American Academy of Pediatrics: Committee on Psychosocial Aspects of Child and Family Health and Committee

2014 eMedicine Pediatrics

10. Precocious Puberty (Diagnosis)

common, benign, normal variant conditions that can resemble precocious puberty but are nonprogressive or very slowly progressive. Premature thelarche refers to the isolated appearance of breast development, usually in girls younger than 3 years; premature pubarche refers to appearance of pubic hair without other signs of puberty in girls or boys younger than 7-8 years. A thorough history, physical examination, and growth curve review can help distinguish these normal variants from true sexual (...) of the normal distribution. Age If precocious puberty in females (mostly central) is defined as the early onset of breast development, then the data of Herman-Giddens et al can be used to estimate frequency of central precocious puberty at different ages in both white girls and black girls. Be cautious, however, in equating breast development in 3-year-olds with central precocious puberty because most such girls actually have premature thelarche, a benign normal variant (see Differentials). The younger

2014 eMedicine Pediatrics

11. Disorders of the Breast (Treatment)

thelarche Benign premature thelarche is defined as isolated breast development in females aged 6 months to 9 years. Physical examination for this entity should carefully seek out other signs of puberty, such as development of pubic hair, thickening of the vaginal mucosa, and accelerated bone growth. If no other signs of puberty are present, reassure the patient and family that this is a benign finding. Examine the child every 6-12 months. If other signs of puberty are evident, precocious puberty should (...) involves antibiotics, needle aspiration, or surgical drainage. The decision for surgical drainage should be carefully made because future breast deformation may occur. For this reason, needle aspiration is the preferred treatment. [ ] The literature suggests that drainage alone, without adjunctive antibiotics, may be effective in skin and soft-tissue abscesses caused by MRSA; no definitive antibiotic recommendation regarding MRSA breast abscesses in particular is recognized. [ ] Benign premature

2014 eMedicine Pediatrics

12. Disorders of the Breast (Overview)

thelarche Benign premature thelarche is defined as isolated breast development in females aged 6 months to 9 years. Physical examination for this entity should carefully seek out other signs of puberty, such as development of pubic hair, thickening of the vaginal mucosa, and accelerated bone growth. If no other signs of puberty are present, reassure the patient and family that this is a benign finding. Examine the child every 6-12 months. If other signs of puberty are evident, precocious puberty should (...) involves antibiotics, needle aspiration, or surgical drainage. The decision for surgical drainage should be carefully made because future breast deformation may occur. For this reason, needle aspiration is the preferred treatment. [ ] The literature suggests that drainage alone, without adjunctive antibiotics, may be effective in skin and soft-tissue abscesses caused by MRSA; no definitive antibiotic recommendation regarding MRSA breast abscesses in particular is recognized. [ ] Benign premature

2014 eMedicine Pediatrics

13. Psychosocial and Environmental Pregnancy Risks (Diagnosis)

. Premature thelarche and alterations in menstruation in humans are speculated to be associated with plant estrogens. Intervention Apart from the avoidance of accumulated DDT and the use of endocrine modulators early in pregnancy, few recommendations can be made definitively about endocrine disrupters. It would be reasonable to suggest that pregnant women avoid the use of certain products in which endocrine disturbers are found to be very prevalent, such as avoiding the excessive consumption of canned

2014 eMedicine.com

14. Breast Embryology

in gym class or remove his shirt at the pool or beach. During this period, the patient or his family may seek consultation and treatment. Reassurance that the condition is most likely temporary provides psychological support and hopefully avoids premature surgical intervention. Use of certain drugs, namely H2 blockers, anabolic steroids, marijuana, and heroin, can prolong the presence of gynecomastia in this population. Gynecomastia also is seen in approximately 40% of males with (trisomy of the sex (...) is initiated during embryologic life but is only complete in the postpartum lactation of the adult female. [ ] After the transient secretion stimulated by prolactin production in the neonate, the mammary glands, with their relatively simple architecture, remain quiescent until puberty. During this period, the supporting stromal structures and ducts enlarge in proportion to the increase in body size of the individual, but no lobular development occurs. Thelarche, the rapid growth that occurs at the onset

2014 eMedicine Surgery

15. Disorders of the Breast (Follow-up)

thelarche Benign premature thelarche is defined as isolated breast development in females aged 6 months to 9 years. Physical examination for this entity should carefully seek out other signs of puberty, such as development of pubic hair, thickening of the vaginal mucosa, and accelerated bone growth. If no other signs of puberty are present, reassure the patient and family that this is a benign finding. Examine the child every 6-12 months. If other signs of puberty are evident, precocious puberty should (...) involves antibiotics, needle aspiration, or surgical drainage. The decision for surgical drainage should be carefully made because future breast deformation may occur. For this reason, needle aspiration is the preferred treatment. [ ] The literature suggests that drainage alone, without adjunctive antibiotics, may be effective in skin and soft-tissue abscesses caused by MRSA; no definitive antibiotic recommendation regarding MRSA breast abscesses in particular is recognized. [ ] Benign premature

2014 eMedicine Pediatrics

16. First-Voided Urinary LH vs. GnRH-stimulation in Differentiating Slowly- From Rapidly Progressive-Precocious Puberty

of impairment of final height (slowly progressive precocious puberty; SP-PP). Other conditions of non-progressive PP include premature thelarche and unsustained PP that is characterized by a regression of sexual precocity. Due to their benign course, slowly progressive (SP) PP and other non-progressive forms of PP do not warrant therapy with GnRH agonists. Differentiating these forms from RP-PP is therefore essential to prevent unnecessary intervention in a population that accounts for at least 50% of girls (...) PP include premature breast budding and unsustained PP that is characterized by a spontaneous regression of sexual precocity. Due to their benign course, slowly progressive (SP) PP and other non-progressive forms of PP do not warrant therapy with GnRH agonists. Differentiating these forms from RP-PP is therefore essential to prevent unnecessary intervention in a population that accounts for at least 50% of girls with PP. A distinction between these forms of PP may be difficult on clinical grounds

2013 Clinical Trials

17. Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar), Tehran (PubMed)

hyperplasia (CAH) (42.8%), ovarian cysts (28.4%), McCune-Albright syndrome (14.2%) and adrenal carcinoma (14.2%). 34.1% of girls and 25% of boys had normal variant puberty including premature thelarche (57%), premature adrenarche (38%) as well as premature menarche (4.7%l).The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH. Therefore precocious puberty in girls (...) is usually benign. In boys, CNS anomalies should first be considered in the differential diagnosis of CPP. Therefore brain Magnetic Resonance Imaging (MRI) is mandatory in all cases.

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2012 Iranian Journal of Reproductive Medicine

18. 9 year old girl with breast development and first period but no axillary or pubic hair. Is this consistent with normal puberty or does this require investigation.

, the 1st pubertal milestone is typically breast development (thelarche), followed soon after by appearance of pubic hair (pubarche) and axillary hair and later by the 1st menstrual period (menarche)…” It adds: “ Premature appearance of only one specific pubertal milestone is generally considered a benign variant of development. Examples are precocious appearance of pubic and axillary hair before age 8 in girls and age 9 in boys, and precocious onset of breast development before age 8 in girls (...) of adrenal androgen secretion. It starts at about the time of apocrine gland sweat production and the common complaint of axillary odour. o Menarche usually occurs about 2-3 years after the start of breast development (thelarche). The median age of menarche is around 13 years in contemporary British teenagers (12 years 11 months). o The growth spurt occurs early in female puberty. It is usually maximal (about 8 cms/year) during Tanner breast stages 2 and 3. It reduces to 4cm/year at menarche.” A table

2008 TRIP Answers

19. Precocious Puberty

slightly earlier in both boys and girls over the past few decades. [ , ] Similar trends have been demonstrated in Europe. [ ] Precocious puberty is often a benign central process in girls but precocious puberty is rarely idiopathic in boys and early signs of puberty in boys are a particular cause for concern. Thelarche is the beginning of breast development and pubarche is the first appearance of pubic hair. Early appearance of these characteristics is more common than true precocious puberty. See (...) and sexually aggressive behaviour in the first 2-3 years of life. Severe hypothyroidism or van Wyk-Grumbach syndrome. Growth is arrested (unusual with precocious puberty) rather than accelerated. Exogenous oestrogen or androgen exposure (therapeutic or accidental.) Benign variants of precocious pubertal development Non-progressive precocious puberty . Following early signs of puberty, the situation stabilises or regresses rather than progressing. Isolated precocious thelarche . Early breast development

2008 Mentor

20. Puberty - Normal and Abnormal

odour. Menarche usually occurs about 2-3 years after the start of breast development (thelarche). In one British cohort study the average age at menarche was 12.9 years and the average duration of puberty was 2.7 years. [ ] The growth spurt occurs earlier in female puberty. It is usually maximal (about 8 cm/year) during Tanner's breast stages 2 and 3. and reduces to 4 cm/year at menarche. Examination May reveal pubic hair and changes in the vaginal mucosa (from red prepubertally to pastel pink (...) growth follow 1-2 years after testicular enlargement. Pubic hair typically appears at a similar time. Pubic hair growth without other changes (premature adrenarche) suggests adrenal androgen production (congenital adrenal hyperplasia (CAH), Cushing's syndrome, adrenal tumour). 50-90% of boys have some degree of breast hypertrophy. Later signs include growth spurt, voice deepening, acne and facial hair. The growth peak starts 2-3 years earlier in girls. Growth spurts start with the hands and feet

2008 Mentor

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