This birthmark boded ill

Little blonde Piper Cramer walks between her tall blonde mother and less tall, dark-haired, white-coated Dr. Sheilagh Maguiness.
Piper Cramer at 8 weeks and 4 years, showing loss of much hemangioma.
Piper Cramer at 8 weeks and 4 years

Birthmarks are commonly benign. Uncommon ones can be deadly.

One common birthmark is the infantile hemangioma, a group of tangled blood vessels found in about four percent of babies. But when Piper Cramer arrived in the world, she had an uncommon form of it. Overnight, it erupted into painful sores that left her unable to eat and threatened to scar her face.

Luckily for the Brookings, South Dakota infant, the U of M had a top pediatric dermatologist to care for her. Sheilagh Maguiness, an associate professor in the Medical School and an M Health Fairview practitioner, recognized the malady.

But Maguiness had never seen a child with a case that affected not only her face, but much of her lower body. She also suspected the hemangioma reached below Piper’s skin, where it would pose a danger to internal organs.

“The skin provides clues as to where else to look,” Maguiness says.

And she was right. An MRI showed anomalies in brain blood vessels that could have left Piper prone to a seizure or stroke.

An intern’s shock

During her internship, Maguiness cared for two infants with very rare blood vessel tumors. Their deaths left her shaken by the scarcity of knowledge about large blood vessel birthmarks.

The young doctor made it her life’s work to learn all she could about childhood skin diseases and what could be done for patients with them. Today she directs the multidisciplinary Center for Pediatric Vascular Anomalies, the only center of its kind in the Midwest.

“There are only 400 pediatric dermatologists in the entire country,” Maguiness says. With three at the U of M, “I feel like we have the dream team."

And if enough future doctors follow her path, it would mean patients like Piper could be treated in greater numbers and closer to home.

No pain, big gain

The vascular anomalies in Piper’s brain turned out to be mild enough not to need treatment, although a neurologist will have to monitor them. But her skin needed help, and fast.

She received a two-part treatment. First, a blood pressure medication—whose great power to reduce hemangiomas was discovered by accident in 2008—did most of the work. A series of laser treatments did the rest.

Today, Piper’s mother looks back at the times she was overwhelmed caring for her first child. Administering morphine to relieve her daughter’s pain was especially stressful.

But that big cloud seems to have come with an even bigger silver lining.

“I don’t think it knocked Piper’s confidence at all,” her mother says. “If anything, it made her strong, resilient, beautiful and unique.”

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