- Hesham A Saleh, consultant rhinologist/ENT surgeon; and honorary senior lecturer1,
- Stephen R Durham, professor of allergy and respiratory medicine; and honorary consultant physician2
- 1Charing Cross and Royal Brompton Hospitals, London; and Imperial College of Medicine, London
- 2Imperial College of Medicine, National Heart and Lung Institute, London; and Royal Brompton Hospital, London
- Correspondence to: H Saleh h.saleh{at}imperial.ac.uk
- Accepted 1 August 2007
Perennial rhinitis can be defined clinically as an inflammatory condition of the nose characterised by nasal obstruction, sneezing, itching, or rhinorrhoea, occurring for an hour or more on most days throughout the year. Rhinitis is commonly managed by both primary and secondary care physicians. Although most cases can be diagnosed and treated in primary care, referral to secondary care is often necessary when patients do not respond to treatment or other diagnoses are suspected. A recent large scale, cross sectional study in six western European countries found that the overall prevalence of rhinitis was 23%.1 The study also showed that the condition is often undiagnosed, as 45% of patients with investigator confirmed allergic rhinitis had not previously received a diagnosis from their physicians. A published review of previous population based studies showed that, as with asthma, both seasonal and perennial rhinitis seem to be increasing.2
Summary points
Perennial allergic rhinitis is a common condition in general practice
The most common allergen is the house dust mite, followed by cats and dogs
Diagnosis is through history and skin prick testing
Patients with unilateral symptoms, especially if they have pain or bleeding, should be referred to an ear, nose, and throat specialist
Avoidance measures should be taken where appropriate
Medical treatment, mainly with antihistamines, topical corticosteroids, or both, is usually highly effective
Immunotherapy is reserved for severe cases in which avoidance measures and medical treatment are either not effective or not tolerated
Surgery is reserved for certain patients who have structural abnormalities
How is perennial rhinitis classified?
Allergic rhinitis
Perennial allergic rhinitis can be more difficult to diagnose than seasonal allergy, particularly if the patient presents with secondary symptoms of sinusitis and a “permanent cold.” The most common allergen to account for perennial allergy symptoms is the house dust mite (Dermatophagoides pteronyssinus). Other common causes are animals, particularly cats, …
Sign in
Personal subscribers, sign in here:
Article access
Article access for 1 day
Purchase this article for £20 $30 €32*
The PDF version can be downloaded as your personal record
CiteULike
Connotea
Del.icio.us
Digg
Facebook
Reddit
Technorati
Twitter
Stumbleupon
Rapid responses
Latest Responses
The decline in the breast cancer incidence is 1.2% and it is not significant.
Published 10 February 2012
'twas ever thus
Published 10 February 2012
The value of historic human remains
Published 10 February 2012
In Praise of British Literature
Published 10 February 2012
Is real shared decision making possible?
Published 10 February 2012
Most responses
Does anyone understand the government’s plan for the NHS? (17 responses)
Published 17 Jan 2012
Bad medicine: medical nutrition (15 responses)
Published 18 Jan 2012
Shared decision making: really putting patients at the centre of healthcare (7 responses)
Published 27 Jan 2012
Why legislation is necessary for my health reforms (7 responses)
Published 1 Feb 2012
Search for evidence goes on (5 responses)
Published 17 Jan 2012