In Reply.—We appreciate the opportunity to respond to the letter pertaining to our article.1 Indeed, we were delighted to see the publication of age-specific corticotropin stimulation data2 that appeared in print only after our article was submitted. These normative data confirm our suspicions that the increased Δ5-17-hydroxypregnenolone and Δ5-17-hydroxypregnenolone—17-hydroxyprogesterone ratios observed in our patients and those of Oberfield et al3 may have reflected "a normal delay in fetal adrenal-zone involution." We agree entirely that decreased 3β-hydroxysteroid activity in infancy is inadequately appreciated, and normative data such as those of Lashansky et al2 will be of benefit in increasing recognition of this developmental phenomenon.
Unfortunately, we still can only speculate on the origin (or origins) of pubic hair development in infancy. As stated, we suspect that some cases may reflect increased sensitivity of pubic hair follicles to normal androgen levels, since pubic hair development
ADAMS DM, YOUNG PC, COPELAND KC. Pubic Hair in Infancy-Reply. Am J Dis Child. 1992;146(10):1132-1133. doi:10.1001/archpedi.1992.02160220018010