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Preliminary clinical studies using the PDT + PDL approach were recently reported. In order to increase safety of the study, PDT light dose was initiated at the very low light dose of 15 J/cm2 and increased by 15 J/cm2 over the course of the study, to a maximum of 75 J/cm2. No significant adverse effects related to treatment were noted. PDT + PDL sites demonstrated increased purpura as compared to the PDL-alone test sites (Fig. 10.5). Purpura is a sign of vascular damage and increased purpura has been associated with improved PWS response. Twc patients demonstrated improved blanching in the PDT+ PDL sites. It is important to note that preliminary animal experiments were conducted using a CW light dosage of 96 J/cm2. Based on these results, greater effect can be expected to be seen in the PDT and PDT + PDL sites as CW light dosage is increased.