{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T01:02:23Z","timestamp":1792544543495,"version":"4.5.0"},"reference-count":45,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Hidradenitis suppurativa (HS) is a chronic-relapsing and debilitating disease, which affects the components of the folliculopilosebaceous unit and severely impacts on the perceived health-related quality of life. Among the possible treatments, dietary interventions, such as fasting, have been described to positively impact on HS. However, nothing is known about the effects of circadian, intermittent fasting, such as the Ramadan fasting. A sample of 55 HS patients (24 males (43.6%) and 31 females (56.4%), mean age 39.65 \u00b1 8.39 years, average disease duration 14.31 \u00b1 7.03 years) was recruited in the present study. The \u201cSeverity of International Hidradenitis Suppurativa Severity Score System\u201d (IHS4) decreased significantly from 11.00 \u00b1 5.88 (before Ramadan) to 10.15 \u00b1 6.45 (after Ramadan), with a mean difference of \u22120.85 \u00b1 0.83 (p &lt; 0.0001). At the univariate analyses, the improvement was associated with HS phenotype (with a prominent improvement among those with ectopic type), treatment (with the improvement being higher in patients receiving topical and systemic antibiotics compared to those treated with biologics), the \u201cAutoinflammatory Disease Damage Index\u201d (ADDI), and Hurley scores. At the multivariate regression analysis, only the Hurley score (regression coefficient = 0.70, p = 0.0003) was found to be an independent predictor of change in the IHS4 score after fasting. The improvement in the IHS4 score was not, however, associated with weight loss. In conclusion, the Ramadan fasting proved to be safe and effective in HS patients. Considering the small sample size and the exploratory nature of the present investigation, further studies in the field are warranted, especially longitudinal, prospective and randomized ones.<\/jats:p>","DOI":"10.3390\/nu11081781","type":"journal-article","created":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T11:39:37Z","timestamp":1564659577000},"page":"1781","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["The Safety and Impact of a Model of Intermittent, Time-Restricted Circadian Fasting (\u201cRamadan Fasting\u201d) on Hidradenitis Suppurativa: Insights from a Multicenter, Observational, Cross-Over, Pilot, Exploratory Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2390-6505","authenticated-orcid":false,"given":"Giovanni","family":"Damiani","sequence":"first","affiliation":[{"name":"Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA"},{"name":"Young Dermatologists Italian Network, Centro Studi GISED, 24122 Bergamo, Italy"},{"name":"Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy"},{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20161 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naim","family":"Mahroum","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Daniele Maria","family":"Pigatto","sequence":"additional","affiliation":[{"name":"Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy"},{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20161 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Pacifico","sequence":"additional","affiliation":[{"name":"Clinical Dermatology Department, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiorgio","family":"Malagoli","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Azienda Ospedaliera San Donato Milanese, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danica","family":"Tiodorovic","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9209-2883","authenticated-orcid":false,"given":"Rosalynn RZ","family":"Conic","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Amital","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-868X","authenticated-orcid":false,"given":"Nicola Luigi","family":"Bragazzi","sequence":"additional","affiliation":[{"name":"Postgraduate School of Public Health, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy"},{"name":"Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics, York University, Toronto, ON M3J 1P3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1404-8027","authenticated-orcid":false,"given":"Abdulla","family":"Watad","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel"},{"name":"Department of Medicine B and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 5265601, Israel"},{"name":"Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds LS7 4SA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2738-8784","authenticated-orcid":false,"given":"Mohammad","family":"Adawi","sequence":"additional","affiliation":[{"name":"Padeh and Ziv Hospitals, Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan 5290002, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1056\/NEJMcp1014163","article-title":"Clinical practice. 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