How does somebody get diagnosed with allergic rhinitis? Well, allergic rhinitis isactually a very common disease, and most ians arevery used to seeing it, and so far and away, the mostcommon way to get diagnosed is actually by history and exam. If a person is displayingall the symptoms, then the diagnosis of allergicrhinitis can be very easy.
For example, if theyhave nasal congestion, if they have nasal discharge, if they have watery, itchyeyes, if they have sneezing. It becomes even easier if youcan show that those symptoms are seasonal or a person actually can show that they react to a specific allergen. In these situations, allergicrhinitis is easy to diagnose, and oftentimes, they’llbe treated successfully
from this point on, but whatif there’s still a question? What if, for example, theydon’t have a seasonal component, or they only have wateryeyes and sneezing? In that case, more information is needed. Oftentimes, the next goto test is something called skin testing. Now, skin testing maysound a little barbaric when I describe it, but it’sactually the most sensitive
and probably the most specific way, other than history, to get at the diagnosis of allergic rhinitis. In order to undergo skin testing, the patient has to havea relatively large patch of skin available for the test. Usually this is doneon the patient’s back. This can also be done on the arm
or any other large area, but the important thing isthat the person has enough room to place multiple tinylittle pricks on the skin, and each one of thesepricks contains an allergen. In other words, each one of these contains something that the personmight be allergic to. Here, I’m going to draw a fewout on this patient’s back, and usually the personthat’s performing this test
will number these with aSharpie or a ballpoint pen just so they can keep them straight so they know exactly whatit is that’s going on. After the allergens are placed on or actually within the skin,15 minutes is allowed to pass. At this point, the skin hashad enough time to react to any of those allergens that aperson might be allergic to. For instance, if thisperson has a skin wheal here
What is allergic rhinitis
Voiceover So whatis Allergic Rhinitis? The part of the word quot;Rhinquot;comes from the Greek root that means nose like inrhinoplasty or rhinoceros. And quot;itisquot; just means inflammation. So this is an inflammation of the nose. And quot;allergicquot; just meansthat it’s caused by allergies. So let’s go ahead and draw our nose here. This is the outside of thenose, but the inside of the nose
is covered with a smooth lining. And that smooth lining is called mucosa. Mucosa lines everything inside your nose. But it’s not just totally smooth in there. There’re these bones that stickout that are called concha. They’re called concha becausethey’re kind of coiled like little snail shells. So we’ll draw those in like this.
This concha kind of stick out from the side of the wall of the nose. And they can take up almostall the space in there. But in order to figure out what’s happening a little bit better, we have to zoom in. And we have to zoom in all the way to the level of the cells.
So here I’m drawing some ofthe cells of the nasal mucosa. And these are big globular pink cells. But there’s a couple cellsin here that are different. And these are cells of your immune system. The ones that we are worriedabout, the immune cells in the nose that dealwith Allergic Rhinitis, are called mast cells and basophils. So let’s say this particularnose and this particular
set of cells has Allergic Rhinitis. What exactly is happening? Well, in Allergic Rhinitis,like with any allergy, your body has an overreaction to some sort of stimulus in the environment. And that stimulus is called an Allergen. And let’s take a little sidenote here and talk about the allergens that arecommon to people who suffer
from Allergic Rhinitis. The most common culprit is pollen. And pollen can come from trees, or grass. In fact, hay can cause AllergicRhinitis and it gives rise to one of the otherterms called Hay Fever. Although technically, AllergicRhinitis isn’t a fever. Pollen also tends to be seasonal. In other words, some types ofpollen are out in the Spring.