DIAGNOSIS CHECKLIST
for Nose symptoms

Why: to determine if acute or chronic.

Why: e.g. nasal obstruction, nasal discharge, abnormal nose shape, deviated nasal septum, nose bleed, sneezing, dry nose, loss of smell, nasal tenderness, red nose, numb nose, itchy nose, rash on nose.

Why: suggests a congenital disorder e.g. Down syndrome is characterized by a snub shaped nose; bifid nose (split into two parts) may occur in association with cleft lip and palate and usually result from genetic factors or being exposed to an agent during the second month of fetal life that causes abnormal fetal development.

Why: may indicate the cause of the nose symptoms s e.g. broken nose, deviated septum, separated septum, nasal septal necrosis, saddle nose deformity.

Why: e.g. allergic rhinitis, Wegener's granulomatosis, Sjogren's syndrome, rosacea, leukemia, sinusitis, bleeding disorder; Rheumatoid arthritis, systemic lupus erythematosus, primary biliary cirrhosis, diabetes insipidus, Raynaud's phenomenon, systemic sclerosis, chronic active hepatitis and vasculitis may all be associated with Sjogren's syndrome.

Why: e.g. antihistamines, lung bronchodilators such as ventolin, drugs that contain atropine and isotretinoin for severe acne may cause a dry nose ; some medications may induce rhinitis including aspirin, phenothiazines, oral contraceptives; Rhinitis medicamentosa is inflammation of the nasal passages following overuse of over the counter decongestant nasal drops or sprays.

Why: allergic rhinitis may be caused by allergies to tree pollen, grasses, moulds, house dust mite, cat fur, bird feathers or some foods.

Why: although it is popularly believed that rhinophyma is caused by alcohol excess, there is no specific association between the two.

Why: e.g. cocaine and marijuana may induce rhinitis.

Why: e.g. smoke and other noxious fumes, paints and sprays and cosmetics may induce rhinitis.

Why: e.g. leprosy is found primarily in Asia or Africa.

Why: If acute nasal obstruction may suggest acute sinusitis, acute rhinitis, a viral upper respiratory tract infection, allergic rhinitis, nasal diphtheria, cluster headache, migraine, foreign body and trauma. If chronic unilateral nasal obstruction may suggest sinusitis, foreign body, nasal tumor, deviated septum, polyps and Wegener's granulomatosis. If chronic bilateral nasal obstruction, it would suggest allergic rhinitis, vasomotor rhinitis, enlarged adenoids, rhinitis medicamentosa and ingestion of drugs such as reserpine.

Why: e.g. pus-like discharge suggests acute sinusitis, Wegener's granulomatosis, nasal tumor, foreign body or syphilis. If the discharge is mucous-like or clear may suggest allergic rhinitis, chronic sinusitis, vasomotor rhinitis, cluster headache, migraine or leakage of cerebrospinal fluid after trauma. If a blood-stained discharge must consider nasopharyngeal cancer.

Why: may be due to a bleeding disorder, high blood pressure, leukemia, idiopathic thrombocytopenic purpura or nasal tumor.

Why: if associated with nasal obstruction may suggest acute sinusitis, acute rhinitis, acute viral upper respiratory tract infection and nasal diphtheria. If associated with nasal discharge consider acute sinusitis, acute viral upper respiratory tract infection or Wegener's granulomatosis.

Why: suggests allergic rhinitis and sinusitis.

Why: suggests acute sinusitis, cluster headache, migraine or nasopharyngeal cancer.

Why: e.g. flat facial profile, snub nose, excess neck skin, unusually shaped ears, round head, protruding tongue, short wide hands.

Why: e.g. bleeding nose, swelling around the eyes, bruising over the nose and around eyes, deformity of the nose. May be complicated by septal deviation, blood clot and abscess formation within the septum or perforation of the septum. If a blood clot and abscess form within the septum, the septum can die and collapse and cause a "saddle nose deformity".

Why: e.g. excessive growth of hands, excessive growth of tissues such as nose, lips and face, excessive growth of feet, increased size of jaw and tongue, weakness, sweating, headaches, loss of menstrual periods, loss of libido and deepening of voice.

Why: e.g.disfiguring enlarged nose with dilated follicles. Due to enlarged sebaceous glands, fibrosis and increased blood vessels. Caused by rosacea and possibly alcohol excess.

Why: e.g. episodic reddening of the face (flushing) with increases in skin temperature in response to heat stimuli in the mouth and alcohol; acne-like rash on the forehead, cheeks, nose and chin. May be complicated by rhinophyma (enlarged nose), enlarged cushion-like swelling of the forehead, swelling of the eyelids, cauliflower-like swelling of the earlobes and swelling of the chin.

Why: e.g. pale skin patches on the face, buttocks, arms and legs; nasal stuffiness, hoarseness of the voice, thinning of the outer part of the eyebrows. May have perforation of the nasal septum with collapse of the cartilage to produce a "saddle nose deformity". With progression of the disease, the typical "lion face" may result due to infiltration of the skin. Leprosy is found primarily in Asia and Africa.

Why: e.g. sneezing; nasal obstruction and congestion; watery nasal discharge; reduced sense of smell; itchy nose, throat and eyes.

Why: e.g. facial pain and tenderness, toothache, post-nasal drip, nasal obstruction, runny nose, cough, fever, bleeding nose Symptoms of nasopharyngeal cancer? - e.g. facial pain, bloody nasal discharge, cranial nerve palsies.

Why: e.g. paroxysmal clusters of severe pain over one side of the eye and head which typically occur nightly, usually 2-3 hours after falling asleep. They occur from 1-3 times a day at regular times like clockwork, last for 15 minutes to 2-3 hours and the clusters last 4-6 weeks. Associated with runny or stuffy nose, runny eye, flushing of forehead and cheek, redness of the eye, vomiting and sometimes droopy eyelid on the same side as the pain.

Why: e.g. dry eyes, dryness of the mouth, dryness of the nasal passages, skin or vagina. This syndrome may be associated with many systemic conditions such as Raynaud's phenomenon, difficulty in swallowing (as seen in systemic sclerosis), painful joints (like that seen with systemic lupus erythematosus), thyroid disease, myasthenia gravis, primary biliary cirrhosis, chronic active hepatitis, renal diabetes insipidus, renal tubular acidosis and vasculitis.

Why: e.g. tiredness, sore runny nose, sneezing, sore throat, slight fever; sometimes headache, hoarseness and cough.

Why: e.g. fever, chills, headache, generalized muscle aches and pains followed by sore throat, dry cough and runny nose.

Why: e.g. fever, malaise, aching muscles, weight loss, cough, shortness of breath, pus-like nasal discharge, bleeding nose, sinus facial pain and aching joints.