Efalizumab in the Treatment of Alopecia, Phase II

Inclusion Criteria: * ability to provide written informed consent and comply with study assessments for the full duration of the study. * clinical diagnosis of alopecia totalis, alopecia universalis, or severe ophiasis variant of alopecia areata. * 18-40 years of age. * if a female of childbearing potential, a negative pregnancy test and commitment to the use of two forms of effective contraception (birth control) for the duration of the study are necessary. * if a non-sterile male, commitment to the use of two forms of effective contraception (birth control) for the duration of the study is necessary. Exclusion Criteria: * known hypersensitivity to efalizumab (Raptiva) or any of its components. * known liver disease, including active hepatitis * history of autoimmune diseases causing alopecia other than alopecia areata. * prior biologic therapy within 6 months prior to study initiation. * history of any malignancy within last ten years, except treated non-melanoma skin cancers. * any woman currently pregnant or lactating. * intake of systemic immunosuppressive agents, including oral corticosteroids, within 3 months prior to study initiation. * history of positive PPD and/or tuberculosis. * history of HIV/AIDS * prior enrollment in any efalizumab study * any condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated. * participation in another simultaneous clinical trial involving investigational agents. * positive HIV screening test obtained at screening visit. * positive QuantiFERON-TB test obtained at screening visit. * positive hepatitis screen obtained at screening visit. * platelet count 150 x 10(9)/L at baseline visit. * presence of any abnormal laboratory value obtained at screening visit assessed as clinically significant by principal investigator.