Hemorrhoids: This is the most common condition that causes lesions or swelling around the anal region, which can break open and bleed. Hemorrhoids are swollen veins in the lowest part of the rectum or anus, and they can be internal or external. The frequent breaking open could be due to straining during bowel movements, poor bowel habits, or increased pressure on the veins.

Anal Fissures: These are small tears in the lining of the anus, which can cause pain and bleeding during and after bowel movements. The tears can break open and may resemble lesions.
Perianal Abscesses: These are collections of pus that can form in the tissue around the anus, often as a result of a bacterial infection. They can appear as painful lesions that may break open and drain.
Pilonidal Sinus or Cyst: A pilonidal sinus is a small hole or tunnel in the skin at the bottom of the tailbone (coccyx), which can become infected and form a cyst. This can cause a lesion that breaks open and drains.

Anal Cancer: Although rare, anal cancer can present with lesions around the anal region. It's crucial to rule out cancer, especially in individuals with risk factors such as human papillomavirus (HPV) infection or a history of immunosuppression.
Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause lesions and ulcers in the anal region, which may break open and bleed.

Hiddenitis Suppurativa: A chronic skin condition that can cause painful lesions and abscesses in the groin and anal areas, although it's more commonly associated with the axillary region.
Lymphogranuloma Venereum (LGV): A sexually transmitted infection caused by certain strains of Chlamydia trachomatis, which can cause lesions, ulcers, and other symptoms in the anal region, especially in individuals who practice receptive anal sex.
Tuberculosis (TB): Although rare, TB can affect the anal region and cause lesions, ulcers, and fistulas, especially in immunocompromised individuals or those from endemic areas.