At a routine well-visit for a 7-month-old in Everett, Washington, Dr. Johanna Arce noticed something she saw often on her infant patients: soft cheeks dotted with dry, pink patches.
It looked like eczema, the kind many babies develop from teething, drool, and the everyday irritations of early life. Still, something caught her attention: a slight yellow scaling. Out of caution, she prescribed mupirocin and placed a referral to dermatology. The earliest available appointment, however, was months away.
Weeks later, she received a report that the patient had gone to the local emergency room, and later, a note about a second visit to the ER.
“After our well visit, they went to the ER twice where they were given antibiotics,” Dr. Arce said. “They were seen and got medication, but the rash was not getting better, so they scheduled a follow-up with me.”
At a follow-up appointment a few weeks later, Dr. Arce carefully revisited the timeline of events with the family, taking extra time to piece together what had happened during the ER visits. The baby’s parents were navigating a language barrier and had not fully understood the details of the care their child had received.
“By the time I saw the child again, the rash was gnarly,” she said.
Noticing the urgency of the situation and that the timeline for the dermatology referral wouldn’t be sufficient, Dr. Arce reached out to MAVEN Project.
“I sent the message and photos to MAVEN during my lunch break then went back to work, busy with other patients,” she said. “The next morning, by the time I went to work at 8 a.m., I had gotten a call and email that this was urgent.”
The consult had reached Dr. Lynn Sydor, a dermatologist with more than three decades of experience.
“I opened the photo and thought, ‘Oh my—this baby was very sick,’” Dr. Sydor said.
What she saw was not eczema. Not even a typical skin infection.
“This is the worst case of eczema herpeticum I’ve ever seen.”
Clusters of punched-out lesions spread across the baby’s face, creeping toward the eye, down the neck, and even a few onto the chest. Herpes simplex virus had entered through broken skin caused by simple eczema, and was now spreading rapidly. In infants, eczema herpeticum is a medical emergency. If the virus reaches the eye, it can lead to blindness and in severe cases, systemic involvement.
Dr. Sydor didn’t wait. She reached out to MAVEN staff who contacted the clinic to flag this case as urgent.
She sent detailed treatment recommendations, and emphasized the need for emergency evaluation, including antiviral medication and an ophthalmology consult. She even reached out to other MAVEN pediatric dermatologists, who all agreed: this baby needed hospital care now.
When Dr. Arce arrived at work that morning, she didn’t hesitate. She called the baby’s mother and told her to go straight to Seattle Children’s Hospital, nearly an hour away.
“While they were on their way, we were able to contact the hospital and mobilize everything so they could be treated as soon as they arrived,” Dr. Arce said. “The biggest concern was how close the rash was to the eye.”
At the hospital, the baby was admitted immediately and quickly evaluated by both dermatology and ophthalmology teams. IV antiviral therapy was initiated, bringing the rapid progression of the virus under control and halting its spread.
Within days, the change was unmistakable.
A week later, Dr. Arce saw the infant again and sent a follow-up photo to the MAVEN team.
“He looked like a different baby,” Dr. Sydor said. “And his eye was okay.”
There was a shared sense of relief.
In community health settings, where specialists aren’t always nearby, decisions carry extra weight. There’s no dermatologist down the hall. No easy second opinion.
Dermatology consultations are among the most requested across the entire MAVEN network, highlighting both the widespread need for specialty support and the limited access many community clinics face.
Behind those consults is a dedicated volunteer network of 16 adult dermatologists and 10 pediatric dermatologists who help bridge critical gaps in specialty care for underserved communities nationwide.
For Dr. Arce, this case reinforced the importance of having that connection.
“I’m really thankful for MAVEN,” she said. “It’s helped me grow in confidence and be more helpful to my patients. I’ve shown this case to other providers in my clinic and we all are more aware of what eczema herpeticum could look like.”
Her work is rooted in a commitment to care for underserved communities, something made easier by her ability to connect with patients in Spanish, her first language.
“I’ve always wanted to work in community health because of health equity,” she said. “I want to provide as much care as possible to underserved populations.”
For Dr. Sydor, the case was equally meaningful.
“I feel an obligation to help,” she said. “This is part of my calling as a doctor.”
After decades in dermatology, Dr. Sydor’s work with MAVEN allows her to continue practicing in a new way, by teaching, guiding, and stepping in when it matters most.
“The primary care physicians taking care of these populations are so overwhelmed and the need is so great,” Dr. Sydor said. “There is no office next door where they can pop over and ask questions. They choose to do this job, so I am honored to help them.”
This case could have gone another way.
A delayed diagnosis. A worsening infection. Possible vision loss.
Instead, a message sent during a lunch break and answered before sunrise changed everything.
“This is why we do what we do,” Dr. Sydor said.
And in Everett, Washington, a baby who once lay uncomfortable and worsening is now back to doing what babies are meant to do— growing, healing, and smiling.
