When a patient with alopecia areata presents in your office, what are some of the most important clinical and psychosocial factors you're evaluating during the first visit?

Yeah, I think that's a really good point there, Jamie.

So it's not only our job as clinicians to look at the physical findings for the patient, but also to recognize when a patient's quality of life impact and their distress misaligned with their physical hair loss or their SALT score.

We should be determining disease severity and treatment urgency holistically, right? So to do this, we can think about our patients in a few different ways.

uh so looking beyond that salt score so acknowledging that a patient who may have more limited or mild scalp involvement they can still experience a tremendous and disproportionate impact on their confidence their relationships and their overall quality of life So in doing that, we can better empathize with our patients and develop insights into what the patient's actually living with.

And then also looking for that psychological sequela.

As good clinicians, we want to look for the presence of anxiety and depression, social avoidance, withdrawal, their diminished self-confidence, or even suicidal thoughts that can all play into it.

So talking about patient selection, when you're thinking about a JAK inhibitor, what do you think are the appropriate candidates? Walk me through that a little bit.