A narrative review of house dust mite allergy: species distribution and allergen sensitisation patterns across tropical regions.

House dust mite (HDM) allergy is among the leading causes of allergic disease worldwide, yet significant knowledge gaps regarding its ecology, prevalence, and diagnostic approaches in tropical regions remain unexplored. The constant warmth and humidity characteristic of the tropics create optimal conditions for mite proliferation and year-round allergen exposure, leading to high sensitisation rates among populations with allergies. This review synthesises current knowledge on the ecology, distribution, and sensitisation patterns of HDM species in tropical environments, with particular attention to Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis. It also examines diagnostic approaches used across tropical countries, ranging from conventional skin prick testing (SPT), specific IgE test and to advanced molecular methods such as Component-Resolved Diagnosis (CRD). By integrating ecological and clinical perspectives, this review highlights the importance of region-specific research and diagnostic strategies that account for species diversity and cross-reactivity unique to tropical settings. Advancing molecular allergen characterisation and developing standardised tropical mite extracts will be essential for improving diagnostic accuracy, guiding immunotherapy, and informing public health policies aimed at reducing the burden of mite-related allergic diseases in tropical populations.