Indonesian pineapple allergen extract for skin prick test as an alternative diagnostic tool in atopic dermatitis

Several fruits have been identified as allergens and potential triggers for exacerbations of atopic dermatitis (AD). This study evaluated pineapple allergy and sensitization among adult patients with AD and examined the diagnostic accuracy of a locally produced pineapple allergen extract in skin prick tests (SPTs). A total of 30 adult patients with AD, with a mean age of 36.07±10.81 years, were enrolled in the study. Firstly, SPT was performed using a standard pineapple allergen extract manufactured by Astromed® (Astromed Inc., West Warwick, Rhode Island, USA). Subsequently, a second SPT was carried out with the pineapple allergen extract produced by Teaching Industry Allergen Dr. Soetomo General Academic Hospital, Universitas Airlangga (Surabaya, Indonesia). Data were analyzed for diagnostic test accuracy and agreement. The local pineapple SPT had a sensitivity of 33.33% and a specificity of 100%. The test exhibited a positive predictive value (PPV) of 100%, whereas the negative predictive value (NPV) was 93.10%. The agreement between the standard SPT and the local SPT was statistically significant, exhibiting moderate concordance (p=0.002). The Indonesian pineapple allergen extract for SPT can serve as an alternative diagnostic tool to assess pineapple allergy and sensitization in AD patients.