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.
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.