Which physical findings are characteristic of allergic rhinitis?

Updated: Jan 02, 2019
  • Author: Quoc A Nguyen, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Patients with allergies frequently have a characteristic physical appearance.

  • Face

    • Patients with allergic rhinitis frequently grimace and twitch their face, in general, and nose, in particular, because of itchy mucus membranes.

    • Chronic mouth breathing secondary to nasal congestion can result in the typical adenoid facies.

  • Eyes

    • Patients may have injected conjunctiva; increased lacrimation; and long, silky eyelashes.

    • Dennie-Morgan lines (creases in the lower eyelid skin) and allergic shiners (dark discoloration below the lower eyelids) caused by venous stasis may be present.

  • Ears

    • Ears are frequently unremarkable.

    • Eczematoid otitis externa and middle ear effusion may be present.

  • Nose

    • A transverse nasal crease may be present because of the patient's repeated lifting of the nasal tip to relieve itching and open the nasal airway.

    • The turbinates are frequently hypertrophic and covered with a boggy pale or bluish mucosa.

    • Nasal secretions can range from clear and profuse to stringy and mucoid.

    • The presence of polyps does not necessarily indicate that the affected individual has allergic rhinitis.

  • Mouth

    • A high arched palate, narrow premaxilla, and receding chin may be present secondary to long-term mouth breathing.

    • The posterior oropharynx may be granular because of irritation from persistent postnasal discharge.


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