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==Overview==
==Overview==
Rhinitis is one of the most common conditions presenting for medical care in several countries.<ref name="Diseases of the Sinuses">{{cite book |last1=Romeo |first1=Jonathan |last2=Dykewicz |first2=Mark |title=Diseases of the Sinuses |publisher=Springer New York |date=2014 |pages=133-152 |chapter=Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis |isbn=978-1-4939-0265-1}}</ref>  It is a heterogenous disorder which is sometimes mistakenly treated with triviality.<ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584  }} </ref> Rhinitis significantly affects the quality of life of affected individuals, and also constitute a huge financial burden to the society.<ref name="pmid15025839">{{cite journal| author=Schoenwetter WF, Dupclay L, Appajosyula S, Botteman MF, Pashos CL| title=Economic impact and quality-of-life burden of allergic rhinitis. | journal=Curr Med Res Opin | year= 2004 | volume= 20 | issue= 3 | pages= 305-17 | pmid=15025839 | doi=10.1185/030079903125003053 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15025839  }} </ref> A careful history and physical examination is essential for accurate diagnosis, treatment, and prevention of the potential complications associated with chronic rhinitis.<ref name="pmid11449200">{{cite journal| author=Skoner DP| title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. | journal=J Allergy Clin Immunol | year= 2001 | volume= 108 | issue= 1 Suppl | pages= S2-8 | pmid=11449200 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11449200  }} </ref><ref name="pmid17153005">{{cite journal| author=Settipane RA, Charnock DR| title=Epidemiology of rhinitis: allergic and nonallergic. | journal=Clin Allergy Immunol | year= 2007 | volume= 19 | issue=  | pages= 23-34 | pmid=17153005 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17153005  }} </ref> It is essential to examine all the organ systems that are potentially affected by allergies.<ref name="pmid18662584">Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al. (2008) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18662584 The diagnosis and management of rhinitis: an updated practice parameter.] ''J Allergy Clin Immunol'' 122 (2 Suppl):S1-84. [http://dx.doi.org/10.1016/j.jaci.2008.06.003 DOI:10.1016/j.jaci.2008.06.003] PMID: [https://pubmed.gov/18662584 18662584]</ref> A detailed examination of the upper respiratory tract should be done in all patients presenting with rhinitis.<ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584  }} </ref
Rhinitis is one of the most common conditions presenting for medical care in several countries.<ref name="Diseases of the Sinuses">{{cite book |last1=Romeo |first1=Jonathan |last2=Dykewicz |first2=Mark |title=Diseases of the Sinuses |publisher=Springer New York |date=2014 |pages=133-152 |chapter=Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis |isbn=978-1-4939-0265-1}}</ref>  It is a heterogenous disorder which is sometimes mistakenly treated with triviality.<ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584  }} </ref> Rhinitis significantly affects the quality of life of affected individuals, and also constitute a huge financial burden to the society.<ref name="pmid15025839">{{cite journal| author=Schoenwetter WF, Dupclay L, Appajosyula S, Botteman MF, Pashos CL| title=Economic impact and quality-of-life burden of allergic rhinitis. | journal=Curr Med Res Opin | year= 2004 | volume= 20 | issue= 3 | pages= 305-17 | pmid=15025839 | doi=10.1185/030079903125003053 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15025839  }} </ref> A careful history and physical examination is essential for accurate diagnosis, treatment, and prevention of the potential complications associated with chronic rhinitis.<ref name="pmid11449200">{{cite journal| author=Skoner DP| title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. | journal=J Allergy Clin Immunol | year= 2001 | volume= 108 | issue= 1 Suppl | pages= S2-8 | pmid=11449200 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11449200  }} </ref><ref name="pmid17153005">{{cite journal| author=Settipane RA, Charnock DR| title=Epidemiology of rhinitis: allergic and nonallergic. | journal=Clin Allergy Immunol | year= 2007 | volume= 19 | issue=  | pages= 23-34 | pmid=17153005 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17153005  }} </ref> It is essential to examine all the organ systems that are potentially affected by allergies.<ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584 }} </ref> A detailed examination of the [[upper respiratory tract]] should be done in all patients presenting with rhinitis.<ref name="pmid18662584">{{cite journal| author=Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al.| title=The diagnosis and management of rhinitis: an updated practice parameter. | journal=J Allergy Clin Immunol | year= 2008 | volume= 122 | issue= 2 Suppl | pages= S1-84 | pmid=18662584 | doi=10.1016/j.jaci.2008.06.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18662584  }} </ref>
==Physical Examination==
==Physical Examination==
The examination of patients with rhinitis should include an examination of the nose, and assessment for possible comorbidities and complications. The physical examination of a patient with rhinitis may reveal the following:<ref name="Allergic rhinitis-an overview of a common disease">{{cite journal |last=Rotiroti |first=Giuseppina |last2=Scadding |first2=Glenis |date=July 2016 |title=Allergic Rhinitis-an overview of a common disease |url=https://www-clinicalkey-com.ezp-prod1.hul.harvard.edu/#!/content/playContent/1-s2.0-S1751722216300063?returnurl=null&referrer=null&scrollTo=%23tbl2|journal=Paediatrics and Child Health |volume= Volume 26 |issue= Issue 7 |pages=298-303 |access-date=January 20, 2017 }} </ref><ref name="pmid20176255">{{cite journal| author=Dykewicz MS, Hamilos DL| title=Rhinitis and sinusitis. | journal=J Allergy Clin Immunol | year= 2010 | volume= 125 | issue= 2 Suppl 2 | pages= S103-15 | pmid=20176255 | doi=10.1016/j.jaci.2009.12.989 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20176255  }} </ref>
The examination of patients with rhinitis should include an examination of the nose, and assessment for possible comorbidities and complications. The physical examination of a patient with rhinitis may reveal the following:<ref name="Allergic rhinitis-an overview of a common disease">{{cite journal |last=Rotiroti |first=Giuseppina |last2=Scadding |first2=Glenis |date=July 2016 |title=Allergic Rhinitis-an overview of a common disease |url=https://www-clinicalkey-com.ezp-prod1.hul.harvard.edu/#!/content/playContent/1-s2.0-S1751722216300063?returnurl=null&referrer=null&scrollTo=%23tbl2|journal=Paediatrics and Child Health |volume= Volume 26 |issue= Issue 7 |pages=298-303 |access-date=January 20, 2017 }} </ref><ref name="pmid20176255">{{cite journal| author=Dykewicz MS, Hamilos DL| title=Rhinitis and sinusitis. | journal=J Allergy Clin Immunol | year= 2010 | volume= 125 | issue= 2 Suppl 2 | pages= S103-15 | pmid=20176255 | doi=10.1016/j.jaci.2009.12.989 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20176255  }} </ref>
===General Appearance===
===General Appearance===
* Rhinorrhea may be seen
* [[Rhinorrhea]] may be seen
* Mouth breathing from nasal congestion
* [[Mouth breathing]] from [[nasal congestion]]
* Sniffing
* Sniffing
* Allergic shiners- Dark eye shadows beneath the lower eye lid due to blood/fluid accumulation in the infraorbital groove as a result of congestion of the nose/sinuses. It is commonly seen in childhood allergic rhinitis, and the degree of darkness is  associated with the chronicity and severity of disease. It can also be seen in nonallergic rhinitis.
* Allergic shiners: Dark eye shadows beneath the lower eye lid due to blood/fluid accumulation in the infraorbital groove as a result of congestion of the nose/sinuses. It is commonly seen in childhood allergic rhinitis, and the degree of darkness is  associated with the chronicity and severity of disease. It can also be seen in nonallergic rhinitis.
* Dennie–Morgan lines- These are wrinkles/ extra skin fold underneath the lower eyelids. It is seen in children with allergic diseases such as allergic rhinitis.
* Dennie–Morgan lines: These are wrinkles/ extra skin fold underneath the lower eyelids. It is seen in children with allergic diseases such as allergic rhinitis.
* Allergic salute- A habitual gesture of rubbing the nose upward because of nasal discomfort and pruritus. It sometimes produces a persistent horizontal crease across the nose.
* Allergic salute- A habitual gesture of rubbing the nose upward because of nasal discomfort and [[pruritus]]. It sometimes produces a persistent horizontal crease across the nose.
{{#ev:youtube|Jfd04SBQjmk}}
{{#ev:youtube|Jfd04SBQjmk}}




===Vital signs===
===Vital signs===
Increased temperature may be seen especially when there is an infectious etiology (infectious rhinitis/[[rhinosinusitis]])
Increased [[temperature]] may be seen especially when there is an infectious etiology (infectious rhinitis/[[rhinosinusitis]])
===HEENT===
===HEENT===
Ocular findings- Commonly seen in patients with allergic rhinitis. Some of the ocular findings include:<ref name="pmid 27490123">{{cite journal| author=Shaker M, Salcone E| title=An update on ocular allergy. | journal=Curr Opin Allergy Clin Immunol | year= 2016 | volume= 16 | issue= 5 | pages= 505-10 | pmid= 27490123 | doi=10.1097/ACI.0000000000000299 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27490123  }} </ref>
'''Ocular findings''': Commonly seen in patients with allergic rhinitis. Some of the ocular findings include:<ref name="pmid 27490123">{{cite journal| author=Shaker M, Salcone E| title=An update on ocular allergy. | journal=Curr Opin Allergy Clin Immunol | year= 2016 | volume= 16 | issue= 5 | pages= 505-10 | pmid= 27490123 | doi=10.1097/ACI.0000000000000299 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27490123  }} </ref>
* Bilateral conjunctival injection, papillae, corneal involvement in severe cases (atopic and vernal keratoconjunctivitis).
* Bilateral [[conjunctival injection]], papillae and cobblestones.
* Frequent rubbing of the eyes, irritability, lacrimation, mucus discharge
* [[Cornea|Corneal]] involvement in severe cases (atopic and [[vernal keratoconjunctivitis]]).
* Blepharospasm
* Frequent rubbing of the eyes, irritability, [[lacrimation]], mucus discharge.
* Periorbital edema
* [[Blepharospasm]]
Nasal findings- Examination of the nasal cavity with a speculum or otoscope may reveal the following:
* [[Periorbital edema]]
* Swollen/edematous turbinates
'''Nasal findings''': Examination of the nasal cavity with a [[speculum]] or [[otoscope]] may reveal the following:
* Pale, bluish or erythematous mucosa. The mucosa is often pale/bluish in allergic rhinitis. Beefy red mucosa can be seen in rhinitis medicamentosa.<ref name="pmid20210811">{{cite journal| author=Varghese M, Glaum MC, Lockey RF| title=Drug-induced rhinitis. | journal=Clin Exp Allergy | year= 2010 | volume= 40 | issue= 3 | pages= 381-4 | pmid=20210811 | doi=10.1111/j.1365-2222.2009.03450.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20210811  }} </ref>
* Swollen/edematous [[turbinates]]
Ear findings- Otoscopic examination of the ears may reveal symptoms suggestive of associated comorbidities such as:
* Pale, bluish or [[erythematous]] [[mucosa]]. The [[mucosa]] is often pale/bluish in allergic rhinitis. Beefy red [[mucosa]] can be seen in rhinitis medicamentosa.<ref name="pmid20210811">{{cite journal| author=Varghese M, Glaum MC, Lockey RF| title=Drug-induced rhinitis. | journal=Clin Exp Allergy | year= 2010 | volume= 40 | issue= 3 | pages= 381-4 | pmid=20210811 | doi=10.1111/j.1365-2222.2009.03450.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20210811  }} </ref>
'''Ear findings''': Otoscopic examination of the ears may reveal signs suggestive of associated co-morbidities such as:
* [[Otitis media with effusion]]- common in patients with allergic rhinitis.
* [[Otitis media with effusion]]- common in patients with allergic rhinitis.
* [[Acute otitis media]]
* [[Acute otitis media]]
Face
'''Face'''
* Facial tenderness/discomfort on palpation of the sinuses. This often occurs when the inflammation extends into the sinuses (rhinosinusitis), and it can be as a result of infection or allergy
* Facial tenderness/discomfort on palpation of the [[Paranasal sinus|sinuses]]. This often occurs when the inflammation extends into the [[sinuses]] ([[rhinosinusitis]]), and it can be as a result of infection or allergy
* Abnormal facial development may be seen especially in chronic mouth breathers.<ref name="pmid11449200">{{cite journal| author=Skoner DP| title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. | journal=J Allergy Clin Immunol | year= 2001 | volume= 108 | issue= 1 Suppl | pages= S2-8 | pmid=11449200 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11449200  }} </ref>
* Abnormal facial development such as elongated facies may be seen, especially in chronic mouth breathers.<ref name="pmid11449200">{{cite journal| author=Skoner DP| title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. | journal=J Allergy Clin Immunol | year= 2001 | volume= 108 | issue= 1 Suppl | pages= S2-8 | pmid=11449200 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11449200  }} </ref>
Neck
'''Mouth and Throat'''
* Swollen lymph nodes may be seen in infectious rhinitis secondary to upper respiratory tract infections.
* Coexisting conditions like hypertrophied adenoids may be seen.
Throat
* Coexisting conditions like hypertrophied adenoids may be seen
* Dental malocclusion frequently occurs in children who are chronic mouth breathers.<ref name="pmid11449200">{{cite journal| author=Skoner DP| title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. | journal=J Allergy Clin Immunol | year= 2001 | volume= 108 | issue= 1 Suppl | pages= S2-8 | pmid=11449200 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11449200  }} </ref>
* Dental malocclusion frequently occurs in children who are chronic mouth breathers.<ref name="pmid11449200">{{cite journal| author=Skoner DP| title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. | journal=J Allergy Clin Immunol | year= 2001 | volume= 108 | issue= 1 Suppl | pages= S2-8 | pmid=11449200 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11449200  }} </ref>
* High arch in the [[palate]]
* Cobblestoning of the [[oropharynx]]
* Posterior drainage of nasal secretions
'''Neck'''
* [[Swollen lymph nodes]] may be seen in infectious rhinitis secondary to [[Upper respiratory tract infection|upper respiratory tract infections]].


===Skin===
===Skin===
* [[Eczema]] may be seen in patients with allergic rhinitis if there is coexisting [[atopic dermatitis]].
* [[Eczema]] may be seen in patients with allergic rhinitis if there is coexisting [[atopic dermatitis]].
===Lungs===
===Chest===
* Wheezing sounds may be heard if comorbid conditions like [[asthma]] is present.
* A thorough chest examination is essential, as it may reveal abnormalities suggestive of other pathological conditions or co-morbidities such as [[respiratory tract infections]], [[asthma]].


==References==
==References==
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[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Otolaryngology]]
[[Category:Immunology]]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]

Overview

Rhinitis is one of the most common conditions presenting for medical care in several countries.[1] It is a heterogenous disorder which is sometimes mistakenly treated with triviality.[2] Rhinitis significantly affects the quality of life of affected individuals, and also constitute a huge financial burden to the society.[3] A careful history and physical examination is essential for accurate diagnosis, treatment, and prevention of the potential complications associated with chronic rhinitis.[4][5] It is essential to examine all the organ systems that are potentially affected by allergies.[2] A detailed examination of the upper respiratory tract should be done in all patients presenting with rhinitis.[2]

Physical Examination

The examination of patients with rhinitis should include an examination of the nose, and assessment for possible comorbidities and complications. The physical examination of a patient with rhinitis may reveal the following:[6][7]

General Appearance

  • Rhinorrhea may be seen
  • Mouth breathing from nasal congestion
  • Sniffing
  • Allergic shiners: Dark eye shadows beneath the lower eye lid due to blood/fluid accumulation in the infraorbital groove as a result of congestion of the nose/sinuses. It is commonly seen in childhood allergic rhinitis, and the degree of darkness is associated with the chronicity and severity of disease. It can also be seen in nonallergic rhinitis.
  • Dennie–Morgan lines: These are wrinkles/ extra skin fold underneath the lower eyelids. It is seen in children with allergic diseases such as allergic rhinitis.
  • Allergic salute- A habitual gesture of rubbing the nose upward because of nasal discomfort and pruritus. It sometimes produces a persistent horizontal crease across the nose.

{{#ev:youtube|Jfd04SBQjmk}}


Vital signs

Increased temperature may be seen especially when there is an infectious etiology (infectious rhinitis/rhinosinusitis)

HEENT

Ocular findings: Commonly seen in patients with allergic rhinitis. Some of the ocular findings include:[8]

Nasal findings: Examination of the nasal cavity with a speculum or otoscope may reveal the following:

Ear findings: Otoscopic examination of the ears may reveal signs suggestive of associated co-morbidities such as:

Face

  • Facial tenderness/discomfort on palpation of the sinuses. This often occurs when the inflammation extends into the sinuses (rhinosinusitis), and it can be as a result of infection or allergy
  • Abnormal facial development such as elongated facies may be seen, especially in chronic mouth breathers.[4]

Mouth and Throat

  • Coexisting conditions like hypertrophied adenoids may be seen.
  • Dental malocclusion frequently occurs in children who are chronic mouth breathers.[4]
  • High arch in the palate
  • Cobblestoning of the oropharynx
  • Posterior drainage of nasal secretions

Neck

Skin

Chest

  • A thorough chest examination is essential, as it may reveal abnormalities suggestive of other pathological conditions or co-morbidities such as respiratory tract infections, asthma.

References

  1. ↑ Romeo, Jonathan; Dykewicz, Mark (2014). "Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis". Diseases of the Sinuses. Springer New York. pp. 133–152. ISBN 978-1-4939-0265-1.
  2. ↑ 2.0 2.1 2.2 Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA; et al. (2008). "The diagnosis and management of rhinitis: an updated practice parameter". J Allergy Clin Immunol. 122 (2 Suppl): S1–84. doi:10.1016/j.jaci.2008.06.003. PMID 18662584.
  3. ↑ Schoenwetter WF, Dupclay L, Appajosyula S, Botteman MF, Pashos CL (2004). "Economic impact and quality-of-life burden of allergic rhinitis". Curr Med Res Opin. 20 (3): 305–17. doi:10.1185/030079903125003053. PMID 15025839.
  4. ↑ 4.0 4.1 4.2 Skoner DP (2001). "Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis". J Allergy Clin Immunol. 108 (1 Suppl): S2–8. PMID 11449200.
  5. ↑ Settipane RA, Charnock DR (2007). "Epidemiology of rhinitis: allergic and nonallergic". Clin Allergy Immunol. 19: 23–34. PMID 17153005.
  6. ↑ Rotiroti, Giuseppina; Scadding, Glenis (July 2016). "Allergic Rhinitis-an overview of a common disease". Paediatrics and Child Health. Volume 26 (Issue 7): 298–303. Retrieved January 20, 2017.
  7. ↑ Dykewicz MS, Hamilos DL (2010). "Rhinitis and sinusitis". J Allergy Clin Immunol. 125 (2 Suppl 2): S103–15. doi:10.1016/j.jaci.2009.12.989. PMID 20176255.
  8. ↑ Shaker M, Salcone E (2016). "An update on ocular allergy". Curr Opin Allergy Clin Immunol. 16 (5): 505–10. doi:10.1097/ACI.0000000000000299. PMID 27490123  27490123 Check |pmid= value (help).
  9. ↑ Varghese M, Glaum MC, Lockey RF (2010). "Drug-induced rhinitis". Clin Exp Allergy. 40 (3): 381–4. doi:10.1111/j.1365-2222.2009.03450.x. PMID 20210811.

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