0-14 I Preadolescent
10-14 II Testes and penis: Increasing size is evident
(testicle length reaches 2.0 cm or more); scrotum integument is thinner and assumes as increased pendulous appearance.
11-15 III Rapid growth peak is passed; nocturnal emissions begin.
Testes and penis: Further increase in size and pigmentation; Leydig's cells (interstitial) first appear at stage II. are now prominent in testes. Hair: More abundant pubic area and present on scrotum; still scanty and finely textured: axillary hair begins.
Breasts: Button-type hypertrophy in 70% of boys at stages II and III. Larynx: Changes in voice caused by laryngeal growth begin. Skin: Increasing activity of sebaceous and sweat glands: beginning of acne, adult body odor.
12-16 IV Testes: Further increase in size (length 4,0 cm or greater); increase in size of penis greatest at stages III and IV
Larynx: Voice deepens
Skin: Increasing pigmentation of scrotum and penis; acne often more severe
Breast: Previous hypertrophy decreased or absent.
13-17 V Testes: Length greater than 4.5 cm.
Hair: Pubic hair thick, curly, heavily pigmented, extends to thighs and toward umbilicus; adult distribution and increase in body hair (chest, shoulders, and thighs) continues for more than another 10 years; baldness, if present may begin.
Larynx: Adult character of voice.
Skin: Acne may persist and increase.
Reproduced with permission from Lowrey GH. Growth and development of children. 7th ed. Chicago: Year Book; 1978.
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