To the Editor:—
Despite the widespread use of estrogens in nonprescription cosmetic creams and lotions during the past two decades, there have been few reports of significant systemic effect. Topical preparations containing less than 10,000 units of estrogen per ounce, in amounts not exceeding 2 oz per month, ie, 20,000 units per month,1 have not been reported to produce detectable systemic effects. The error of this assumption, at least for the pediatric age group, is illustrated by the present case report.
Report of a Case:—
A 3 3/12-year-old white girl was admitted to the Hartford Hospital for evaluation of isosexual precocity and a presumptative functional ovarian tumor. This child had normal growth and development until approximately six months prior to admission when the parents noted fullness of the breasts. Transient improvement occurred, although further breast enlargement was again noted by the parents three months prior to admission. One week