Dermatological diseases of the perianal region may be due to systemic disorders, atopic dermatitis, lichen simplex chronicus, psoriasis vulgaris, seborrheic dermatitis, lichen sclerosus, allergic or irritant contact dermatitis and bacterial, fungal, parasitic or viral infections. Candidiasis, oxyuriasis, psoriasis and inflammatory bowel disease seem to be the most important diagnoses in clinical practice. Perianal eczema is fairly common, but there are only few studies elucidating the causal epidemiologic factors, namely the identification of relevant contact allergens. Reports of perianal contact dermatitis are not frequent, but even more uncommon is the reference to self-perpetuation of the skin lesions. The authors describe the case of a male, middle-aged bus driver, with perianal and buttock eczema caused by contact allergy to anesthetics and fragrances, that we believe, was intentionally perpetuated by continued use of anti-hemorrhoidal ointments.

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