Allergic Rhinitis

Allergic rhinitis often called allergies or hay fever occurs when your immune system overreacts to particles in the air that you breathe you are allergic to them. Your immune system attacks the particles in your body, causing symptoms such as sneezing and a runny nose. The particles are called allergens, which simply means they can cause an allergic reaction.

People with allergies usually have symptoms for many years. You may have symptoms often during the year, or just at certain times. You also may get other problems such as sinusitis and ear infections as a result of your allergies.

Over time, allergens may begin to affect you less, and your symptoms may not be as severe as they had been.

What are the symptoms of allergic rhinitis?

In most cases, when you have allergic rhinitis:

• You sneeze again and again, especially after you wake up in the morning.
• You have a runny nose and postnasal drip. The drainage from a runny nose caused by allergies is usually clear and thin. But it may become thicker and cloudy or yellowish if you get a nasal or sinus infection.
• Your eyes are watery and itchy.
• Your ears, nose, and throat are itchy.

Which allergens commonly cause allergic rhinitis?

ou probably know that pollens from trees, grasses, and weeds cause allergic rhinitis. Many people have allergies to dust mites, animal dander, cockroaches, and mold as well. Things in the workplace, such as cereal grain, wood dust, chemicals, or lab animals, can also cause allergic rhinitis.

If you are allergic to pollens, you may have symptoms only at certain times of the year. If you are allergic to dust mites and indoor allergens, you may have symptoms all the time.

Allergic Asthma

Asthma is a breathing disorder characterized by inflammation of the airways and recurrent episodes of breathing difficulty. These episodes sometimes referred to as asthma attacks, are triggered by irritation of the inflamed airways. In allergic asthma, the attacks occur when substances known as allergens are inhaled, causing an allergic reaction. Allergens are harmless substances that the body’s immune system mistakenly reacts to as though they are harmful. Common allergens include pollen, dust, animal dander, and mold. The immune response leads to the symptoms of asthma. Allergic asthma is the most common form of the disorder.

An asthma attack is characterized by tightening of the muscles around the airways (bronchoconstriction), which narrows the airway and makes breathing difficult. Additionally, the immune reaction can lead to swelling of the airways and overproduction of mucus. During an attack, an affected individual can experience chest tightness, wheezing, shortness of breath, and coughing. Over time, the muscles around the airways can become enlarged (hypertrophied), further narrowing the airways.

Signs and symptoms

Signs and symptoms of asthma include the following:

• Wheezing
• Coughing
• Shortness of breath
• Chest tightness/pain

What causes asthma symptoms?

People with asthma have sensitive airways that are inflamed and are ready to react to triggers that ‘set off’ symptoms. Although asthma is complicated, there are two main ways that symptoms can be set off:

• If you have allergic asthma, your symptoms are caused by an allergic reaction when you come into contact with an allergen (a substance that triggers an allergic reaction). Common allergens include pollen, pets, and house dust mites.
• If you have non-allergic asthma, your symptoms are caused by an irritant you breathe in or another factor but are not caused by an allergic reaction. Common irritants include cigarette smoke and car exhaust fumes. Common factors that can trigger asthma symptoms include exercise, cold weather, colds, and flu.

It is possible that your asthma symptoms can be caused by allergic and non-allergic triggers, which means you can have both allergic and non-allergic asthma.

Urticaria

Urticaria, commonly referred to as hives, appears as raised, well-circumscribed areas of erythema and edema involving the dermis and epidermis that are very pruritic. It may be acute (6 wk). Urticaria may be confused with a variety of other dermatologic diseases that are similar in appearance and are also pruritic; usually, however, it can be distinguished from these diseases by an experienced clinician.

Signs and symptoms

The physical examination should focus on conditions that might precipitate urticaria or could be potentially life-threatening and include the following:

• Angioedema of the lips, tongue, or larynx.
• Individual urticarial lesions that are painful, long-lasting (>24 h), or ecchymotic or that leave residual hyperpigmentation or ecchymosis upon resolution are suggestive of urticarial vasculitis.
• Scleral icterus, hepatic enlargement, or tenderness
• Thyromegaly
• Pneumonia or bronchospasm
• Cutaneous evidence of bacterial or fungal infection

Physical urticaria is characterized by the following:

• Blanchable, raised, palpable wheels, which can be linear, annular (circular), or arcuate (serpiginous); can occur on any skin area; are usually transient and migratory, and may coalesce rapidly to form large areas of erythematous, raised lesions that blanch with pressure
• Dermographism or dermatographism (urticarial lesions resulting from light scratching)

Atopic dermatitis

Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease of unknown origin that usually starts in early infancy, but also affects a substantial number of adults. The cause of atopic dermatitis isn’t clear, but it affects your skin’s ability to hold moisture. Your skin becomes dry, itchy, and easily irritated. Most people who have atopic dermatitis have a personal or family history of allergies, such as hay fever (allergic rhinitis) or asthma.

Things that may make atopic dermatitis worse include:

• Allergens, such as dust mites or animal dander.
• Harsh soaps or detergents.
• Weather changes, especially dry and cold.
• Stress
• An allergic reaction to certain foods, such as eggs, peanuts, milk, wheat, fish, or soy products.
• Skin infection

What are the symptoms?

Atopic dermatitis starts with dry skin that is often very itchy. Scratching causes the dry skin to become red and irritated (inflamed). Infection often occurs. Tiny bumps that look like little blisters may appear and ooze fluid or crust over. This symptoms-dryness, itchiness, scratching, and inflammation may come and go. Over time, a recurring rash can lead to tough and thickened skin.

Mild atopic dermatitis affects a small area of skin, isn’t very itchy, and usually goes away with moisturizer. Severe atopic dermatitis covers a large area of skin that is very itchy and doesn’t go away with moisturizer.

People tend to get the rash on certain parts of the body, depending on their age. Common sites for babies include the scalp and face (especially on the cheeks), the front of the knees, and the back of the elbows. In children, common areas include the neck, wrists, legs, ankles, the creases of elbows or knees, and between the buttocks. In adults, the rash often appears in the creases of the elbows or knees and on the nape of the neck.