Understanding Allergic Rhinitis: Differential Diagnosis and Management

Abstract

Chronic rhinitis is a common condition responsible for a substantial morbidity. Allergic rhinitis is the most frequent reason for chronic rhinitis in children. The physician must begin any evaluation with a thorough history and physical examination. Specific questions concerning the environment will be important if allergy is a possible diagnosis. The microscopic examination of nasal secretions may be helpful in corroborating evidence. Treatment of allergic rhinitis should include a serious attempt to avoid exacerbating factors that have been identified from the history. Pharmacologic intervention with antihistamines, decongestants, and topical use of cromolyn or corticosteroids may be highly successful. If such therapy must be constant to achieve an adequate therapeutic response or if the response is suboptimal, an evaluation for specific allergies, including skin testing to identify pertinent allergens, should be considered.