Psoriasis: Given the presence of skin tags with scales all over the body for the last three months and the lack of improvement with hydrocortisone, psoriasis is a strong consideration. The condition often presents with scaly plaques and can be associated with other symptoms like hemorrhoids, although the direct link is less common.

Seborrheic Dermatitis: This condition can cause a skin rash with scales, particularly on oily areas of the body. It might not fully explain the hemorrhoids but could account for the skin symptoms.
Eczema (Atopic Dermatitis): Eczema can present with skin rashes and might not respond to hydrocortisone if the condition is severe or if the patient has developed a tolerance. It's less likely to cause the specific pattern of skin tags described but remains a possibility.
Fungal Infections: Certain fungal infections can cause skin rashes with scales and might not respond to steroid treatments like hydrocortisone. They could potentially explain some of the symptoms.

Cutaneous Lymphoma (e.g., Mycosis Fungoides): Although rare, cutaneous lymphomas can present with skin rashes and lesions that do not respond to conventional treatments. Missing this diagnosis could have severe consequences.
Sarcoidosis: This condition can cause skin lesions and rashes, among other systemic symptoms. It's crucial not to miss sarcoidosis due to its potential for serious complications if left untreated.
Infectious Diseases (e.g., Syphilis, HIV): Certain infectious diseases can cause a wide range of skin symptoms, including rashes and lesions. These conditions require prompt diagnosis and treatment to prevent long-term consequences.

Darier's Disease: A rare genetic disorder that affects the skin, causing lesions and sometimes resembling a rash. It's an unlikely cause but could be considered if other diagnoses are ruled out.
Keratosis Pilaris: A condition that causes small, rough patches on the skin, which might resemble the described skin tags. However, it typically doesn't present with scales all over the body.
Neurofibromatosis: A genetic disorder that can cause skin tags (neurofibromas) among other symptoms. The presence of hemorrhoids and the specific description of the rash makes this a less likely but not impossible diagnosis.