5 α-Reductase Type 2 Deficiency — Response to Dihydrotestosterone Gel: Authors’ Reply

Abstract

To the Editor: We read with great interest the letter by Ammini et al. on our article “5 α-reductase type 2 deficiency—Response to dihydrotestosterone gel” [1]. While Ammini et al. observed increased penile length in response to dihydrotestosterone gel in a 13-y-old child who was clearly in pubertal development, we observed almost similar magnitude of response in our patient at the age of one year. We opine that if treatment is initiated at a young age, it may help in lessening parental anxiety. There is a preferance towards male genitoplasty in these patients as reported by Ammini et al. in their cohort [2]. Similar gender reversal at puberty has been described in 56–63 % of patients with 5-α reductase deficiency from Dominican Republic, New Guinea, south Lebanon and Turkey who had been raised as females [3]. Early detection and management will make adjustment to gender reversal smoother with less psychological stress to the patient. While hCG treatment is successful in some of the patients with isolated cryptorchidism, surgical correction may be required for co-existing chordee after suitable increase in penile length with dihydrotestosterone gel.