From the Guidelines
Dust mite allergy typically presents with symptoms such as nasal congestion, runny nose, itchy nose, or sneezing, as well as clear rhinorrhea, nasal congestion, pale discoloration of the nasal mucosa, and red and watery eyes, as outlined in the clinical practice guideline for allergic rhinitis 1. The presentation of dust mite allergy can be similar to other respiratory allergies, and may include symptoms such as:
- Sneezing
- Runny or stuffy nose
- Itchy or red eyes
- Nasal congestion
- Postnasal drip
- Cough
- Facial pressure or pain These symptoms may worsen in the morning or when sleeping, as dust mites are commonly found in bedding, and can be perennial (year-round) rather than seasonal, as dust mites can thrive indoors regardless of outdoor conditions, though they may increase during humid weather 1. Some individuals may experience skin reactions such as eczema or hives when their skin comes into contact with dust mite allergens, and in more severe cases, dust mite allergy can trigger asthma symptoms including wheezing, chest tightness, difficulty breathing, and coughing, particularly at night or early morning. The diagnosis of dust mite allergy typically involves a combination of clinical history, physical examination, and specific allergy testing such as skin prick tests or blood tests to confirm dust mite sensitivity, as recommended in the guideline 1. The clinical diagnosis of allergic rhinitis, including dust mite allergy, should be made when patients present with a history and physical examination consistent with an allergic cause and one or more of the following symptoms: nasal congestion, runny nose, itchy nose, or sneezing, as stated in the guideline 1.
From the Research
Presentation of Dust Mite Allergy
The presentation of dust mite allergy can vary, but common symptoms include:
- Nasal itching, sneezing, obstruction, and rhinorrhea
- Conjunctival itching, lacrimation, and conjunctival hyperemia
- Cough, wheezing, and chest tightness 2 These symptoms can be persistent and chronic, even during asymptomatic periods, and are characterized by chronic inflammation 2.
Diagnostic Techniques
Diagnostic techniques for dust mite allergy include:
- Skin prick test
- Specific IgE testing
- Component-resolved diagnosis using purified and recombinant allergens, which can improve the accuracy of specific IgE testing 3 However, these techniques can be confounded by cross-reactivity, and the availability of component-resolved diagnosis is limited 3.
Treatment Options
Treatment options for dust mite allergy are limited and include:
- Dust mite avoidance, which is widely recommended but has variable evidence for its efficacy 3, 4
- Pharmacotherapy, which can provide symptom relief but does not extend beyond the end of treatment 3
- Allergen immunotherapy, which has a poor but improving evidence base and can provide long-term benefits 3, 5, 6 Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) have demonstrated effectiveness in allergic rhinitis and asthma, and can provide disease modification and long-term benefits 5, 6.