Differential Diagnosis for a 19-Month-Old with Hair on Labia
- Single Most Likely Diagnosis
- Premature adrenarche: This condition is characterized by the early onset of androgen-mediated changes, such as pubic hair growth, before the age of 8 in girls. It can be caused by an early increase in adrenal androgen production and is often benign.
- Other Likely Diagnoses
- Familial precocious puberty: Some families may have a history of early puberty, which can manifest as premature adrenarche or true precocious puberty.
- Exogenous androgen exposure: Exposure to androgen-containing substances, such as certain creams or supplements, can cause virilization in young children, including the growth of pubic hair.
- Do Not Miss Diagnoses
- Congenital adrenal hyperplasia (CAH): This is a group of genetic disorders that affect the adrenal glands, leading to an overproduction of androgens. CAH can cause virilization in females, including the growth of pubic hair, and can be life-threatening if not treated promptly.
- Androgen-producing tumor: Although rare, tumors that produce androgens, such as certain types of ovarian or adrenal tumors, can cause virilization in young children.
- Rare Diagnoses
- McCune-Albright syndrome: This is a rare genetic disorder that affects the bones, skin, and endocrine system, and can cause premature adrenarche or true precocious puberty.
- Hypertrichosis: This is a rare condition characterized by excessive hair growth all over the body, which can be congenital or acquired.