Chronic rhinitis in adults.

Chronic rhinitis afflicts many American adults; the exact number is unknown because of the difficulty in establishing an exact diagnosis and because of the likely presence of overlap syndromes, including perennial allergic rhinitis, perennial nonallergic rhinitis with eosinophilia, and so-called vasomotor rhinitis. Nasal allergic reactions with release of pharmacologically active chemical mediators can participate in the pathogenesis of chronic rhinitis. In addition, reflex mechanisms probably play an important role in the initiation and maintenance of chronic nasal symptoms. Diagnosis is best achieved by a detailed history, with special attention to home, environmental, and occupation-related exposures and to selective epicutaneous skin tests and repeated smears of nasal secretions for detection of eosinophils. Therapy includes avoidance of all sorts of dust, fumes, sprays, and the like and appropriate attention to minimizing home environmental and occupational exposures. Pharmacotherapy is discussed elsewhere in this supplement.