====== Rhinitis ======


Rhinitis, also known as coryza, is irritation and inflammation of the mucous membrane inside the nose. Common symptoms are a stuffy nose, runny nose, sneezing, and post-nasal drip. The inflammation is caused by viruses, bacteria, irritants or allergens.

===== Classification =====


Rhinitis Classification can be categorized based on etiology, clinical presentation, duration, and underlying mechanisms. Below is a structured overview of the classification:

1. Based on Etiology

a. Allergic Rhinitis:

Seasonal Allergic Rhinitis (SAR):

Triggered by seasonal allergens (e.g., pollen from trees, grasses, or weeds).

Commonly referred to as "hay fever."

Perennial Allergic Rhinitis (PAR):

Caused by year-round allergens (e.g., dust mites, mold, pet dander).

Occupational Allergic Rhinitis:

Triggered by workplace allergens (e.g., latex, flour, chemicals).

b. Non-Allergic Rhinitis:

Vasomotor Rhinitis:

Triggered by non-specific stimuli like smoke, strong odors, temperature changes, or stress.

Hormonal Rhinitis:

Associated with hormonal changes during pregnancy, puberty, or hypothyroidism.

Drug-Induced Rhinitis:

Due to medications such as:

Nasal decongestants (overuse causes rhinitis medicamentosa).

Beta-blockers or ACE inhibitors.

Oral contraceptives.

Gustatory Rhinitis:

Triggered by spicy or hot foods.

Idiopathic Rhinitis:

Non-allergic rhinitis with no identifiable cause.

c. Infectious Rhinitis:

Acute Viral Rhinitis:

Common cold caused by rhinovirus, adenovirus, or other respiratory viruses.

Acute Bacterial Rhinitis:

Secondary bacterial infections, often in conjunction with sinusitis.

Chronic Infectious Rhinitis:

Rare, seen in immunocompromised individuals or chronic bacterial infections.

d. Structural or Mechanical Rhinitis:

Caused by anatomical abnormalities such as:

Deviated nasal septum.

Nasal polyps.

Tumors or foreign bodies (common in children).

e. Systemic Disease-Associated Rhinitis:

Seen in systemic conditions such as:

Granulomatosis with polyangiitis (Wegener’s).

Sarcoidosis.

Sjögren’s syndrome.

f. Cerebrospinal Fluid (CSF) Leak Rhinitis:

Mimics rhinorrhea but caused by a breach in the dura mater leading to clear fluid discharge.

2. Based on Mechanisms

a. Immune-Mediated Rhinitis:

Allergic rhinitis involves IgE-mediated hypersensitivity.

Autoimmune-related rhinitis is seen in vasculitis or systemic diseases.

b. Neurogenic Rhinitis:

Results from autonomic nervous system imbalance, as seen in vasomotor rhinitis.

c. Infectious Rhinitis:

Pathogen-induced inflammation of the nasal mucosa.

3. Based on Duration

a. Acute Rhinitis:

Symptoms last less than 4 weeks.

Commonly due to viral infections or allergies.

b. Chronic Rhinitis:

Symptoms persist for more than 12 weeks.

Often associated with structural abnormalities, allergies, or chronic infections.

c. Recurrent Rhinitis:

Episodes recur periodically, with symptom-free intervals in between.

4. Based on Symptomatology

a. Rhinorrhea-Dominant Rhinitis:

Excessive nasal discharge as the primary symptom (e.g., allergic rhinitis).

b. Obstruction-Dominant Rhinitis:

Nasal blockage or congestion is predominant (e.g., structural rhinitis, polyps).

c. Mixed Symptom Rhinitis:

Combination of rhinorrhea, obstruction, sneezing, and pruritus.

5. Special Types of Rhinitis

a. Atrophic Rhinitis:

Characterized by thinning and atrophy of the nasal mucosa.

Associated with crusting, foul smell (ozena), and nasal obstruction.

b. Honeymoon Rhinitis:

Triggered by autonomic activation during sexual activity or orgasm.

c. Cold-Induced Rhinitis:

Triggered by exposure to cold air.

d. Occupational Rhinitis:

Caused by repeated exposure to irritants or allergens in the workplace.