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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma

IMPACT FACTOR 2018: 1.239

CiteScore 2018: 1.22

SCImago Journal Rank (SJR) 2018: 0.507
Source Normalized Impact per Paper (SNIP) 2018: 0.562

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Volume 29, Issue 1


Prepubertal gynecomastia and chronic lavender exposure: report of three cases

Alejandro Diaz / Laura Luque / Zain Badar / Steve Kornic / Marco Danon
Published Online: 2015-09-03 | DOI: https://doi.org/10.1515/jpem-2015-0248


Introduction: Prepubertal gynecomastia is a rare condition characterized by the growth of breast tissue in males as a consequence of early exposure to sexual hormones. When this condition is present, pathological sources of testosterone/estrogen production, such as adrenal or gonadal tumors must be searched for. A few reports have described an association between gynecomastia and substances that produce stimulation of the estrogen receptor, such as lavender and tea tree oil.

Methods: Here we describe the cases of three boys who presented with prepubertal gynecomastia and were chronically exposed to lavender. Two of these boys were exposed to a cologne, named agua de violetas, used by Hispanic communities in the US, and in their countries of origin.

Results: We studied a sample of the cologne used by one of the patients. Analysis of the chemical composition of the agua de violetas cologne was performed using high-performance liquid chromatography as well as off-line mass spectrometric detection. All these, combined with the physical appearance and the smell, determined that the cologne had lavender as an ingredient.

Conclusion: Exposure to estrogenic substances, such as lavender, should be explored in children presenting with prepubertal gynecomastia/thelarche.

Keywords: breast tissue; estrogens; lavender; prepubertal gynecomastia


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About the article

Corresponding author: Alejandro Diaz, MD, Division of Pediatric Endocrinology, Nicklaus Children’s Hospital, 3100 S.W., 62nd Avenue, Miami, FL 33155, USA, Phone: +(305) 6628368, E-mail:

Received: 2015-06-18

Accepted: 2015-08-03

Published Online: 2015-09-03

Published in Print: 2016-01-01

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 29, Issue 1, Pages 103–107, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2015-0248.

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