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Definition
Symptoms of rhinitis (nasal blockage, rhinorrhea, anosmia) lasting more than 12 weeks.
Classification
Allergic Rhinitis
seasonal perennial
Non-allergic rhinitis
Vasomotor rhinitis Rhinitis medicamentosa Chronic infectious rhinitis Hormonal rhinitis Occupational rhinitis
Allergic Rhinitis
Definition
allergic rhinitis is an inflammatory disorder in which histamine and other chemical mediators (cytokines, leukotrienes) producing the symptoms are released from mast cells in response to specific IgE antibodies
Classification
seasonal: Occur or are increased during certain seasons, usually depending on the pollination of plants to which the patient is allergic perennial: constant, with little seasonal variation, although they may vary in intensity. symptoms are lighter, but usually with more complication
Symptoms
repeated sneezing attacks profuse and watery rhinorrhea nasal obstruction itchy nose and eye lacrimation
Sign
Anterior rhinoscopy: edematous, pale, mucosa; profuse and watery secretion allergic shiner - dark circle under eyes allergic salute - constant rubbing of the tip of the nose with the hand allergic crease
classification
by interval:
intermittent: symptoms last less than 4 days/week OR less than 4 weeks persistent: symptoms last morethan 4 days/week AND more than 4 weeks
severity:
mild: no disturbance of sleep, work, daily activities moderate severe: One or more disturbance mentioned above are found
Diagnosis
specific IgE examination (RAST or ELISA) nose cytology examination skin prick test
Treatment
Avoidance and elimination Antihistamin Corticosteroid
Vasomotor Rhinitis
Etiology (hypothesis):
neurogenic: parasympathetic > sympathetic neuropeptide: substance P, calcitonin gene related protein NO Trauma
Symptoms
triggered by nonspecific stimuli nasal blockage, alternating (left and right) mucoid or serous rhinorrhea sneezers, runners, blockers
Sign:
edematous mucosa, dark red concha
Rhinitis medicamentosa
Definition: disturbance of normal vasomotor response caused by topical vasoconstrictor drug in a long time Patof:
vasoconstrictor drug abuse decrease sensitivity of a-adrenergic receptor parasympathetic become dominant rebound congestion
Symptoms:
nasal blockage continuous rhinorrhea
Sign:
Hypertrophic concha hypertrophic concha unresponsive by adrenalin
Hormonal rhinitis
Pregnancy, menstrual cycles, and occasionally hypothyroidism can lead to rhinitis, usually characterized by nasal congestion. A cyclical pattern may be discernible to the patient.
Occupational rhinitis
Many airborne substances may cause nasal irritation including chemicals, wood dust, animal exposures, and even molds producing mycotoxins (e.g. Aspergillus). Identification of triggering factors and avoidance measures constitute the mainstay of treatment for this problem.