Phase II Randomized Bilateral Comparison of Topical Targretin Gel 1% in Alopecia Areata

Inclusion Criteria:

1. Clinical diagnosis of alopecia areata, alopecia totalis, or alopecia universalis.
2. Patients must be 18 years of age to participate.
3. Patients with alopecia areata must have at least two distinct alopecia areata patches >1.0 cm diameter, one located on the right and left sides each of the scalp. Patients with alopecia totalis or universalis will not have distinct alopecia patches but will have complete or total alopecia on both the sides of the scalp. Patients with alopecia totalis or universalis will have one side of the scalp treated. The patient must agree to treat only one side of the scalp with drug, to have photos taken, and to return for follow-up visits.
4. They must also agree to practice two reliable forms of contraception (hormonal, IUD, double barrier) to be used simultaneously unless abstinence is the chosen method during the entire period of treatment and for at least one month after treatment is discontinued.
5. Men with sexual partners who are of childbearing potential or pregnant must use condoms during sexual intercourse during Targretin® gel therapy and for one month after the last application.
6. Patients will be asked to voluntarily contribute pre- and post biopsies for research studies (3 mm punch biopsies for hematoxylin and eosin (H&E) staining and immunohistochemistry of T-cells). However, failure to consent to biopsies will not exclude them from the study.
7. Patients have signed the informed consent.

Exclusion Criteria:

1. Must be off other topical treatment for alopecia areata or PUVA (psoralen + UVA) therapy for at least two weeks.
2. Must have discontinued intralesional steroids or any systemic therapies that are immunosuppressive or that may affect alopecia areata for at least four weeks. Patients who are on chronic oral steroids are not eligible for the study.
3. Women who are pregnant or breastfeeding are excluded. The pregnancy test will be sensitive to at least 25 mlU/ml.
4. Patients with hepatitis, HIV or other serious infections are excluded.
5. Known hypersensitivity to Targretin® drug or to any retinoid or to any ingredient in the study medication.
6. Patients must not have participated in any other investigational drug study within 4 weeks of entry.
7. Patients with Hbg < 9.5 g/dL, WBC < 2,500 K/ul, Platelets < 100 K/ul, TSH > 5.5 or < 0.5 mcU/mL, T4 < 0.9 or > 1.8 g/dl, or fasting triglyceride level > 350 mg/dl will not be eligible to participate in the study.