Snapshot A 15-year-old boy presents with clear fluid discharge from his nose for 2 days duration. His also reports having episodes of sneezing, feelings of congestion, and a cough. His symptoms only occuring during the spring months and finds it difficult to walk outside without exacerbating his symptoms. On nasal exam, the mucosa and turbinates appear edematous. Introduction Definition inflammation of the mucosa of the nasal passages Rhinitis types allergic rhinitis nonallergic rhinitis etiologies include vasomotor hormonal drug-induced occupational (secondary to irritant exposure) pregnancy Associated conditions sinusitis asthma atopic dermatitis allergic conjunctivitis nasal polyps Epidemiology Incidence allergic rhinitis is the most common form of rhinitis Etiology Aeroallergens Pathogenesis aeroallergens leads to an IgE type I hypersensitivity and mast cell degranulation Presentations Symptoms sneezing congestion rhinorrhea nasal itching Studies Making the diagnosis this is a clinical diagnosis Allergic skin testing confirms that the patients has an allergy to the aeroallergen is not necessary for the diagnosis Differential Nonallergic rhinitis drug-induced rhinitis differentiating factors onset after starting the inciting medication (e.g., angiotensin-converting enzyme inhibitors and phosphodiesterase-5 inhibitors) occupational rhinitis differentiating factors caused by allergens or irritants in the workplace atrophic rhinitis differentiating factors seen in older patients who had many sinus and nasal surgeries Treatment Conservative allergen avoidance indication a component of the management of rhinitis Medical glucocorticoid nasal sprays indication first-line treatment for persistent or moderate-to-severe allergic rhinitis medications budesonide fluticasone Complications Respiratory tract infections