Characterizing Rhinitis Subtypes

Background Allergic rhinitis (AR) is estimated to affect 20–25% of the United States population and thus accounts for a significant portion of our annual total health care expenditure, especially when one includes all of the concomitant disorders associated with rhinitis such as asthma and sinusitis. Given the prevalence of chronic rhinitis, the significant comorbidities associated with this condition, its overall health burden, and dissatisfaction by allergy sufferers with treatment outcomes, it is essential that the allergist and otolaryngologist develop a consensus approach for the evaluation, diagnosis, and treatment of chronic rhinitis subtypes. Methods This study was designed to achieve this end point. Investigators have taken several clinical, physiological, and mechanistic approaches toward better characterizing rhinitis subtypes. An accurate diagnosis directed at differentiating AR, nonallergic rhinitis, and mixed rhinitis is essential to ensure that treatment(s) prescribed will lead to more favorable clinical outcomes. Results An accurate history taking into account age of symptom onset, family history, quantification of inciting allergic and/or nonallergic triggers, and seasonality followed by aeroallergen skin testing to assess atopic status has been shown to be the most useful approach for clearly differentiating rhinitis subtypes. Conclusion Other cellular, cytokine, genetic, and physiological markers have thus far been proven to be less useful. Ultimately, treatment response to medications will be most effective when they are individualized to the patient's diagnosis.