Optimal Management of Allergic Rhinitis
Allergic children may give the 'allergic salute', rubbing their nose upwards, leading to a crease across the nasal bridge, and may also have an extra skin fold or line under their lower eyelids (Denny–Morgan lines). Allergic shiners (dark eye shadows beneath the lower eye lid), caused by fluid accumulation in the infraorbital groove, are typical of childhood AR being darker in severe chronic AR. Frequent throat clearing or hoarseness can be another feature. Internal nasal examination, by otoscope or endoscope, is essential, to rule out alternatives such as nasal polyps.
Examination
Allergic children may give the 'allergic salute', rubbing their nose upwards, leading to a crease across the nasal bridge, and may also have an extra skin fold or line under their lower eyelids (Denny–Morgan lines). Allergic shiners (dark eye shadows beneath the lower eye lid), caused by fluid accumulation in the infraorbital groove, are typical of childhood AR being darker in severe chronic AR. Frequent throat clearing or hoarseness can be another feature. Internal nasal examination, by otoscope or endoscope, is essential, to rule out alternatives such as nasal polyps.