A 55-year-old male presents with complaints of soiling his underwear and discomfort sitting. He has a history of hemorrhoids. On examination, there is evidence of excoriated skin around the anus. What might be the cause, and what is the potential treatment?
The patient's symptoms and history of hemorrhoids suggest the likelihood of hemorrhoidal disease leading to mucus discharge and subsequent perianal skin irritation and excoriation. Treatment would involve measures to control the hemorrhoids, such as dietary changes, avoiding straining during bowel movements, and possibly topical treatments. The perianal skin irritation might be managed with gentle cleaning, drying, and the application of barrier creams.