EpistemisPharyngeal pruritus
Specialty: Otolaryngology.
Why it occurs
- Seasonal allergic rhinitis with retronasal drip of inflammatory mediators
- Oral allergy syndrome (cross reaction between pollens and fresh foods such as fruits or nuts)
- Simple chronic pharyngitis exacerbated by dry environment or oral breathing due to nasal obstruction
- Initial phases of acute viral or bacterial pharyngotonsillitis
Initial workup
Detailed examination of the oropharynx and nasal passages using nasofibroscopy, performing allergy skin tests (prick tests), and pharyngeal smear if there are signs of suspected acute bacterial tonsillitis with an atypical course.
red flags
Difficulty swallowing saliva (sialorrhea due to extreme odynophagia), dyspnea or acute inspiratory stridor, visible angioneurotic edema of the uvula, lips or tongue, sudden generalized pruritic skin rash, or history of an insect bite or ingestion of a new food or risky drug.
Standard management
- Second-generation systemic antihistamines such as rupatadine or bilastine — 10-20 mg orally every 24 hours
- Nasal inhaled corticosteroids if there is associated allergic postnasal drip
- Local anesthetic pharyngeal mouthwashes or sprays with benzydamine or lidocaine occasionally
- Use of demulcent candies that stimulate saliva secretion and lubricate the pharyngeal mucosa.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Otolaryngology
- Listed causes
- 4
- Treatment options
- 4