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Rhinitis
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Vinay Mehta, Srinivasan Ramanuja, Pramod S Kelkar
Physical examination may reveal several characteristic facial features; these include ‘allergic facies’, (highly arched palate, open mouth due to mouth breathing, and dental malocclusion), ‘allergic shiners’ (infraorbital dark circles related to subcutaneous venodilatation), ‘allergic gape’ (open-mouth breathing from nasal blockage), and ‘allergic salute’ (a transverse nasal crease caused by repeated rubbing and pushing the tip of the nose up with the hand).
Nasal problems in the athlete
Published in John W. Dickinson, James H. Hull, Complete Guide to Respiratory Care in Athletes, 2020
Signs of allergic rhinitis include mouth breathing, nasal speech, sniffing, nose rubbing (referred to as ‘the allergic salute’) and throat clearing. A transverse nasal crease may be visible, as well as ‘allergic shiners’ – dark circles under the eyes, which may be accompanied by so-called Dennie-Morgan folds in the skin beneath the eyes. Patients may have signs of other allergic diseases such as skin changes of eczema and wheeze and cough due to asthma.
Epistaxis
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Mary-Louise Montague, Nicola E. Starritt
The most common findings are crusting (two-thirds of children) and visible vessels (40–50% of children) on the anterior septum.15,16 Hallmarks of allergic rhinitis may be present including a transverse nasal skin crease (‘the allergic salute’), and periorbital markers such as ‘allergic shiners’ and ‘Dennie–Morgan lines’. Pale or bluish nasal mucosa and turbinates are also typical in allergic rhinitis. A nasal foreign body should be excluded. Distortion of nasal anatomy, an intranasal mass, polyps or cervical lymphadenopathy should raise the suspicion of tumour and also prompt a screen for cranial nerve palsies.
Comparing available treatments for pollen-induced allergic rhinitis in children
Published in Expert Review of Clinical Immunology, 2022
Angela Klain, Cristiana Indolfi, Giulio Dinardo, Fabio Decimo, Maria Angela Tosca, Michele Miraglia Del Giudice, Giorgio Ciprandi
The diagnosis of PIAR is based on: i) the medical history, such as demonstrating an association between exposure to the pollen allergen exposure and the outbreak of symptoms, ii) the typical symptoms, characterized by nasal and ocular itching, sneezing, rhinorrhea, nasal obstruction during the pollen season, and iii) and documentation of sensitization, such as the production of allergen-specific IgE. Some clinical signs on physical examination may include allergic shiners, allergic salute, pale nasal mucosa, cobblestoning of the nose, and posterior oropharynx. The following diagnostic step is to perform the skin prick test and the measurement of total and allergen-specific serum IgE for suspected allergens. In recent years, thanks to the technology of recombinant allergens, it has been possible to analyze the IgE reactivity to the individual molecular components of an allergen extract. This method allows identifying the reactivity profile of a subject sensitized to the individual allergenic components, increasing their specificity. This technology is termed component-resolved diagnosis (CRD). In addition, molecular allergy diagnostics allows us to identify the immuno-sensitization profile of allergic subjects, improving diagnostic accuracy and allowing discriminatory co-sensitization versus cross-sensitization phenomena [9,10]. In other words, CRD allows identifying the real causal allergens, excluding false sensitizations.