ALLERGIC RHINITIS

DIAGNOSTIC CRITERIA

Definition: Immediate and delayed responses of the nasal mucosa to air-borne allergens.

1. The Commonest Allergic disorder in practice.
2. Due to seasonal allergens (causing ‘Seasonal rhinitis’) like pollens and mold spores or year- round allergens (causing ‘Perennial rhinitis’) like house dust mites, animal proteins from cats, dogs, horses, chicken feathers, cockroaches, indoor molds etc.
3. Other causes could be smoke, cold-air (‘vasomotor’), pregnancy, hypothyroidism (‘hormonal’), drugs like topical decongestants, antihypertensives, antidepressants (‘medicamentosa’), infection, and food induced.
4. Features include Sneezing, running nose, and / or blocked nose, Early morning sneezing common in dust allergy.
5. Ocular symptoms of allergic conjunctivitis with itching, lacrimation and injection usually associated.
6. Severe itching in the nose leading to rubbing the nose-up, leading to horizontal pigmented (Darner’s) Line on the nose, attendant dark pigmentation around lower eyelids due to venous congestion. Pale or violaceous mucosa on turbinates, Nasal polyps are often seen.
7. Latent or overt asthma may be noted alongside.

Prognosis : Tends to be chronic, but much could be done to control symptoms, if individually tailored therapy is given early.

MANAGEMENT

General Principles:

1. Symptomatic in most cases. 
2. One starts with environment control

General Measures

• Keeping environment dust free by mopping the bed room floor with wet mop! use of a air purifiers and dust filters! discouraging sleeping on the floor) plastic covers for pillows and mattresses substituting synthetic material like acrylic for animal products like wool, horsehair in bedding.