Areola and papilla forming secondary mound in adolescent girls is classified under which stage of sexual maturity rating (SMR)?

Ans: C (SMR Stage 4) Ref: Nelson Textbook of Pediatrics, 19th edition. Pg 651Explanation:Classification of Sex Maturity States in GirlsSMRStagePubic HairBreasts1PreadolescentPreadolescent2Sparse, lightly pigmented, straight, medial border of labiaBreast and papilla elevated as small mound; diameter of areola increased3Darker, beginning to curl, increased amountBreast and areola enlarged, no contour separation4Coarse, curly, abundant, but less than in adultAreola and papilla form secondary mound5Adult feminine triangle, spread to medial surface of thighsMature, nipple projects, areola part of general breast contourClassification of Sex Maturity States in BoysSMRStagePubic HairPenisTestes1NonePreadolescentPreadolescent2Scanty, long,slightlypigmentedMinimal change.' enlargementEnlarged scrotum, pink, texture altered3Darker, starting to curl, small amountLengthensLarger4Resembles adult type, but less quantity; coarse, curlyLarger; glans and breadth increase in sizeLarger, scrotum dark5Adultdistribution, spread to medial surface of thighsAdult sizeAdult size