Differentiating Rhinitis in the Paediatric Population by Giving Focus on Medical History and Clinical Examination

Doulaptsi, Maria; Aoi, Noriaki; Kawauchi, Hideyuki; Milioni, Athanasia; Karatzanis, Alexander; Prokopakis, Emmanuel

"Atopic march" represents a sequence of atopic disorders from atopic dermatitis in infants to allergic rhinitis and asthma in childhood [19] . Manifestations of the disease and comorbidities should always be sought during history and physical examination. Bear in mind, those comorbidities may be undiagnosed and have escaped parental attention. Symptoms and signs suggestive of conjunctivitis, asthma, eczema, rhinosinusitis, pollen food allergy, hearing, and sleep disorders should be sought. History of coughing, shortness of breath, and wheezing should alert us for asthma co-existence. Always assess speech and language development delay, high TV volume, poor concentration, and performance at school. Assess symptoms and signs indicative of disturbed sleep such as apnoea, snoring, and day tiredness [10] . The nose is located strategically in the airway and is functionally linked to paranasal sinuses, eyes, middle ears, pharynx, larynx, and lower airway. Hence, apart from classic symptoms of AR, presenting features may be conjunctivitis, chronic cough, mouth breathing, nasal speech, snoring, pruritic mouth and throat, and/or pain of ears on pressure changes.