rhinitis medicamentosa


Also found in: Wikipedia.

rhi·ni·tis me·di·ca·men·to·sa

inflammation of the nasal mucous membrane secondary to excessive or improper topical medication.

rebound rhinitis

A noninfectious, nonallergic rhinitis caused by rebound vasodilation linked to the use of topical vasoconstricting decongestant sprays for more than 4–6 days.

Clinical findings
Nasal congestion, which responds poorly to increased use of decongestants; patients may snore.

Endoscopy
Nasal mucosa is often beefy-red with punctate bleeding, granular or boggy, with patchy tissue friability and profuse stringy mucoid discharge.
 
DiffDx
Allergic rhinitis, continuous positive airway pressure (CPAP) rhinitis, nasal polyps, non-allergic rhinitis, rhinosinusitis.

Reasons for use of decongestants
Allergy, nonallergic rhinoplasty, chronic rhinosinusitis, nasal polyps, night-time continuous positive airway pressure (CPAP), upper respiratory tract infection.
 
Management
Discontinue decongestants ASAP; oral corticosteroids. 

Pathology
Nasociliary loss, squamous cell metaplasia, epithelial oedema, epithelial cell denudation, goblet cell hyperplasia, increase in epidermal growth factor receptor, inflammation.

rhinitis medicamentosa

ENT A complication of chronic topical nasal decongestant use, in which there is a progressive shortening of therapeutic efficacy, coupled with rebound rhinitis after treatment is discontinued. See Allergic rhinitis, Decongestant.
References in periodicals archive ?
Various medical conditions including intrinsic rhinitis, allergic rhinitis, rhinitis medicamentosa and chronic hypertrophic rhinitis can also often result in hypertrophy of the inferior turbinates.
The use of alpha-adrenergic decongestant sprays for more than 5 to 7 days can induce rebound congestion on withdrawal, known as rhinitis medicamentosa.
The cause for inferior turbinate hypertrophy was allergic rhinitis in 41patients, rhinitis medicamentosa in 22 patients, idiopathic rhinitis in 19 patients, chronic rhino sinusitis in 9 patients, and deviated nasal septum in 9 patients.
Additionally, the prolonged use of these drugs can induce rhinitis medicamentosa (Black and Remsen, 1980; Suleimani and Walker, 2007).
However, the benefit of topical decongestants often leads to the overuse of this form of therapy, which may lead to rebound or rhinitis medicamentosa.
Nasal turbinate congestion could indicate a viral aetiology, allergic or irritative rhinitis or rhinitis medicamentosa due to decongestant abuse.
Patients in this group have conditions of varying etiologies, such as vasomotor rhinitis, atrophic rhinitis, rhinitis medicamentosa, nonallergic rhinitis with eosinophilia, chronic rhinosinusitis, metabolic conditions, structural obstruction, and physical or chemical irritation of the nose.
11) While the intranasal agents are faster than the oral formulations, the duration of treatment is limited to less than 10 days to prevent rhinitis medicamentosa (11); intranasal decongestants are not used as long-term therapy except during severe symptoms.
Rhinitis medicamentosa is a special case, caused by the overuse of topical decongestants.
Rhinitis medicamentosa occurs when topical decongestants (nasal sprays) are used in excess.
Patients can use preservative-free drugs in PFP N and not worry about the potential side effects of some preservatives or the short- and long-term consequences, such as rhinitis medicamentosa ("rebound nasal congestion").