Cobblestone Appearance of the Nasopharyngeal Mucosa.

A 27-year-old male presented with a 2-year history of paroxysmal sneezing and nasal congestion, which mostly occurred during April to June. Flexible fiberoptic rhinoscopy revealed slight hypertrophy of both inferior turbinates, with a normal pinkish hue and a marked cobblestone appearance of the nasopharyngeal mucosa, particularly at the torus tubarius and superior segment of the fossa of Rosenmuller (Figure 1). With a positive skin prick test result, a diagnosis of allergic rhinitis was made. The patient was underwent sublingual allergen-specific immunotherapy that was combined with the administration of antihistamines and an intranasal steroid at the start of treatment. At follow-up, 6 months after the start of treatment, the patient reported marked relief from his allergic rhinitis symptoms, and on performing flexible fiberoptic rhinoscopy, he did not show signs of cobblestone mucosa.