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Addressing a Rash of Allergies: A Photo Essay

Addressing a Rash of Allergies: A Photo Essay

allergic rhinitis

Case 1:

The “allergic triad” consists of allergic shiners, allergic salute, and allergic crease.

This girl shows no edema of lids, no blepharoconjunctivitis, and no chemosis. Her mouth is closed, so it may be inferred that she is nose-breathing. She has pressed her right palm against the tip of her nose, pushing it toward her midface to compress the nose and widen the external aperture of each naris. There are faint darkenings of skin beneath each eye.

She has allergic rhinitis, the most common chronic disorder of children.

Allergic shiners take time to develop and a long time to resolve, although they may lighten. They should not occur in uncomplicated seasonal allergic rhinitis. Their predictive value for allergic rhinitis is debated.

Much has been published about the appearance of the nasal mucosa in allergic rhinitis versus viral illness versus rhinitis medicamentosa. However, most clinicians would interpret the total picture and not take this facet as determinative in isolation.

Case and photo courtesy of James Bartley, MD

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