{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:04:44Z","timestamp":1780031084218,"version":"3.53.1"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Cutaneous polyarteritis nodosa (CPAN) is a chronic, relapsing vasculitis frequently associated with glucocorticoid dependence and the absence of standardized treatment algorithms. Therapeutic decisions are largely empirical and management of refractory disease remains challenging.<\/jats:p>\n <\/jats:sec>\n \n Case presentation<\/jats:title>\n We report a patient with refractory CPAN and persistent steroid dependence despite corticosteroids and conventional immunosuppressive therapies. A deliberately planned, time-limited induction strategy with tocilizumab (TCZ) was implemented to achieve rapid disease control and enable steroid withdrawal, followed by maintenance with mycophenolate mofetil (MMF).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n TCZ led to rapid clinical remission after two infusions, allowing progressive steroid tapering and discontinuation. After six doses, TCZ was stopped and MMF was introduced as maintenance therapy. The patient remains lesion-free at the time of manuscript submission.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n A time-limited IL-6 blockade strategy may allow rapid steroid withdrawal and facilitate transition to conventional maintenance in refractory CPAN. This approach may reduce cumulative exposure to both glucocorticoids and biologic agents.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1861077","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:46:09Z","timestamp":1780029969000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Tocilizumab as time-limited induction therapy enabling steroid withdrawal and conventional maintenance in refractory cutaneous polyarteritis nodosa"],"prefix":"10.3389","volume":"13","author":[{"given":"Ka Wei Katty","family":"Joo Hu","sequence":"first","affiliation":[{"name":"Facultad de Medicina, Universidad del Desarrollo-Cl\u00ednica Alemana de Santiago","place":["Santiago, Chile"]},{"name":"Laboratorio de Inmunomodulaci\u00f3n Neuroendocrina, Facultad de Medicina, Instituto de Ciencias Biom\u00e9dicas, Universidad de Chile","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Jaederlund","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad del Desarrollo-Cl\u00ednica Alemana de Santiago","place":["Santiago, Chile"]},{"name":"Laboratorio de Inmunomodulaci\u00f3n Neuroendocrina, Facultad de Medicina, Instituto de Ciencias Biom\u00e9dicas, Universidad de Chile","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Lohse","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad del Desarrollo-Cl\u00ednica Alemana de Santiago","place":["Santiago, Chile"]},{"name":"Servicio de Dermatolog\u00eda, Cl\u00ednica Alemana de Santiago, Universidad del Desarrollo","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Karsulovic","sequence":"additional","affiliation":[{"name":"Laboratorio de Inmunomodulaci\u00f3n Neuroendocrina, Facultad de Medicina, Instituto de Ciencias Biom\u00e9dicas, Universidad de Chile","place":["Santiago, Chile"]},{"name":"Servicio de Reumatolog\u00eda, Cl\u00ednica Alemana de Santiago, Universidad del Desarrollo","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia","family":"Hojman","sequence":"additional","affiliation":[{"name":"Laboratorio de Inmunomodulaci\u00f3n Neuroendocrina, Facultad de Medicina, Instituto de Ciencias Biom\u00e9dicas, Universidad de Chile","place":["Santiago, Chile"]},{"name":"Servicio de Dermatolog\u00eda, Cl\u00ednica Alemana de Santiago, Universidad del Desarrollo","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"B1","article-title":"Polyarteritis nodosa","volume-title":"StatPearls.","author":"Stanton","year":"2024"},{"key":"B2","doi-asserted-by":"publisher","first-page":"4039","DOI":"10.1093\/rheumatology\/keab402","article-title":"Therapeutic options for cutaneous polyarteritis nodosa: a systematic review","volume":"60","author":"Papachristodoulou","year":"2021","journal-title":"Rheumatology"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.1016\/j.jaad.2022.06.009","article-title":"Cutaneous polyarteritis nodosa: diagnosis and treatment. A retrospective case series","volume":"87","author":"Stewart","year":"2022","journal-title":"J Am Acad Dermatol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"104033","DOI":"10.1016\/j.lpm.2020.104033","article-title":"Management of cutaneous vasculitis","volume":"49","author":"Micheletti","year":"2020","journal-title":"Presse Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1007\/s00296-018-4210-2","article-title":"Tocilizumab treatment in refractory polyarteritis nodosa: a case report and review of the literature","volume":"39","author":"Krusche","year":"2019","journal-title":"Rheumatol Int."},{"key":"B6","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1093\/rheumatology\/keac332","article-title":"Use of biologics to treat relapsing and\/or refractory polyarteritis nodosa: data from a European collaborative study","volume":"62","author":"Hadjadj","year":"2023","journal-title":"Rheumatology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1016\/j.jaad.2021.06.872","article-title":"Efficacy and safety of treatments in cutaneous polyarteritis nodosa: a French observational retrospective study","volume":"86","author":"Bettuzzi","year":"2022","journal-title":"J Am Acad Dermatol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1016\/j.jaad.2025.11.014","article-title":"Tocilizumab for refractory and\/or relapsing polyarteritis nodosa","volume":"94","author":"Cottu","year":"2026","journal-title":"J Am Acad Dermatol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.55563\/clinexprheumatol\/477rzo","article-title":"Tocilizumab in polyarteritis nodosa and DADA2: a systematic review","volume":"43","author":"Torun","year":"2025","journal-title":"Clin Exp Rheumatol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1002\/acr.24633","article-title":"2021 American College of Rheumatology\/vasculitis foundation guideline for the management of polyarteritis nodosa","volume":"73","author":"Chung","year":"2021","journal-title":"Arthritis Care Res."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1861077\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:46:40Z","timestamp":1780030000000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1861077\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":10,"alternative-id":["10.3389\/fmed.2026.1861077"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1861077","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]},"article-number":"1861077"}}