A Pain in the Bottom

 Bottom:  “Ready.  Name what part I am for, and proceed.” A Mid-Summer Night’s Dream, I, ii. Abstract: Over a one-month period a 17-year-old male presented with severe recurrent rectal discomfort clinically diagnosed as proctitis with anal fissure.  Both episodes responded to a course of antibiotics and topical steroid ointments.  On clinical examination the degree of rectal mucositis corresponded to that of his anterior oral mucosa, apparent side effects of oral isotretinoin therapy.  A history of constipation may have contributed to the finding of anal fissure.  Several similar cases have been documented in the medical literature.  Clinicians would do well to consider the possibility of isotretinoin-induced proctitis in patients on oral … Continue reading

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