• Presumptive diagnosis of allergic rhinitis may be made in the presence of nasal congestion, sneezing, and itchy nose/palate/eyes with a pattern of allergic triggers.
  • Definitive diagnosis would require specific IgE reactivity during skin-prick or in vitro testing, but a therapeutic trial may be ordered on the basis of a presumptive clinical diagnosis.
  • Treatment consists of allergen avoidance where possible and pharmacotherapy (antihistamines, corticosteroids, cromolyn, decongestants, leukotriene receptor antagonists).
  • Intranasal corticosteroids remain the single most effective class of medications for treating allergic rhinitis.
  • Basic environmental modifications directed at reducing exposure to dander, dust mite, and irritants (e.g., tobacco smoke) are important measures for patients sensitive to these items, and can often be recommended empirically based on the patient's history.

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