• Combined sub-threshold photodynamic and pulsed dye laser therapy can be used to safely achieve improved PWS lesion lightening as compared to either sub-threshold photodynamic therapy or pulsed dye laser therapy alone. [ Time Frame: 90 minutes ] [ Designated as safety issue: No ]
  

Procedures will be performed at the Surgery Laser Clinic at the Beckman Laser Institute at the University of California Irvine.

At an initial visit, a brief history and physical will be performed.

The history will include: 1) previous treatment to my PWS; 2) current medications; 3) history of light sensitivity; 4) risk of pregnancy and use of birth control if a female of child-bearing age.

The physical will include: 1) measurement and evaluation of PWS; 2) measurement of blood pressure, blood cell count, general chemistries (including liver function tests) and ANA, which might indicate an increased sensitivity to light.

On the day of treatment, the same brief physical and history will be repeated. A urine pregnancy test will be performed if a female of childbearing age.

Four circular test sites of PWS will be selected. One test site will receive no treatment. The second test sites will be treated with the pulsed dye laser at standard setting and protective eyeglasses to shield the eyes during the laser treatment.

For two additional test spots, the photodynamic therapy (PDT)verteporfin by intravenous over a 10-minute period. After receiving the verteporfin, the skin and eyes will be sensitive to light for the next 5 days. The light sensitive protection precautions will be instructed.

optical Doppler tomography unit(ODT) measurements, similar to shining a flash light to PWS and measuring the light response,which provide information about how blood is flowing through the PWS.

Photographs and light measurements will be taken follow-up visits at 1 day, 3 days, 1, 2, 4, 8 and 12 weeks after the study treatment, at these visits blood may also be drawn at these follow-up visits to check for blood substances that promote blood vessel formation.

At the end of the study, blood tests will be drawn to assess cell count and general chemistries.

Inclusion Criteria:

• Adult 18 years and older
• Have a PWS on an area other than the face
• a negative pregnancy test and non pregnant or nursing

Exclusion Criteria:

• under 18 years of age
• have an allergy to verteporfin, porfimer sodium or other porphyrins
• have a history of porphyria (a disease that can cause sensitivity to light)
• have had treatment to the PWS test sites in the last 8 weeks
• have an active uncontrolled infection or other significant disease
• currently using medications that will make sensitive to light such as tetracyclines, sulfonamides, phenothiazines, sulfonylurea hypoglycemic agents, thiazide diuretics and griseofulvin
• currently using medications that increase bleeding including aspirin, coumadin or non-steroidal anti-inflammatory drugs.
• have very dark skin which sensitive to laser treatment
• have a positive ANA (lab tests which indicates sensitive to light)