Systemic illness

Diabetes mellitus

Hyperbilirubinemia

Leukemia

Aplastic anemia

Thyroid disease

Mechanical factors

Chronic diarrhea

Chronic constipation

Anal incontinence

Soaps, deodorants, perfumes

Over-vigorous cleansing

Hemorrhoids producing leakage

Prolapsed hemorrhoids

Alcohol-based anal wipes

Rectal prolapse

Anal papilloma

Anal fissure

Anal fistula

Tight-fitting clothes

Allergy to dyes in toilet paper

Intolerance to fabric softener

Skin sensitivity from foods

Tomatoes

Caffeinated beverages

Beer

Citrus products

Milk products

Dermatologi conditions

Psoriasis

Seborrheic dermatitis

Intertrigo

Neurodermatitis

Bowen's disease

Various squamous disorders

Atopic dermatitis

Lichen planus

Lichen sclerosis

Contact dermatitis

Infections

Erythrasma (Corynebacterium)

Intertrigo (Candida)

Herpes simplex virus

Human papillomavirus

Pinworms (Enterobius)

Scabies

Local bacterial abscess

Gonorrhea

Syphilis

Medications

Colchicine

Quinidine