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Rhinitis Medicamentosa
Case description
The chronic use of topical nasal decongestants produces a state of chronic rhinitis, which is known as "Rhinitis Medicamentosa". Topical vasoconstrictors cause such severe constriction of the blood vessels of the nasal mucosa that ischemic mucosal changes develop. Consequently, when the vasoconstrictor's effect wears off, the nasal mucosa "rebounds" becoming reddened and edematous. The patient than experiences increase nasal obstruction re-applies the decongestant thereby establishing a vicious cycle. On examination, the nasal mucous membranes are usually fiery red and swollen. The history of topical decongestant abuse is usually freely given.
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