Prepubertal gynecomastia and chronic lavender exposure: report of three cases.
BACKGROUND
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.


CONCLUSIONS
Exposure to estrogenic substances, such as lavender, should be explored in children presenting with prepubertal gynecomastia/thelarche.
Alejandro
A
Diaz
Laura
L
Luque
Zain
Z
Badar
Steve
S
Kornic
Marco
M
Danon
D002648:Child; D006177:Gynecomastia / Q000139:chemically induced* / Q000175:diagnosis*; D006801:Humans; D027523:Lavandula / Q000737:chemistry*; D008297:Male; D009822:Oils, Volatile / Q000009:adverse effects*; D010938:Plant Oils / Q000009:adverse effects*; D011627:Puberty / Q000187:drug effects*
D009822:Oils, Volatile; D010938:Plant Oils; C045718:lavender oil