Get a clear framework for approaching female hair loss in clinic. This episode walks through how to quickly flag scarring alopecia that needs urgent derm, distinguish female-pattern hair loss from chronic telogen effluvium and alopecia areata, choose and monitor treatments like topical and oral minoxidil (with when to add antiandrogens), and support patients through the psychological impact and when to escalate to biopsy.
SourceOlsen EA. Hair Loss in Women. N Engl J Med. 2025;393(15):1509-1520. doi:10.1056/NEJMcp2412146Subscribe to the Point of Care Medicine Substack.
Get a practical handle on when superficial fungal infections need pills, not creams. This episode covers why terbinafine is first-line for tinea capitis and onychomycosis, how long to treat based on site, when (and how) to confirm the diagnosis before committing to months of therapy, why topical steroids can create tinea incognito, and what to do when standard terbinafine fails.
Source: Caplan AS, Gold JAW, Smith DJ, Ely JW. Diagnosis and Management of Tinea Infections. Am Fam Physician. 2025;112(4):382-392.
Learn how to quickly sort benign drug rashes from true dermatologic emergencies at the bedside. This episode walks through morbilliform eruptions, leukocytoclastic vasculitis, AGEP, phototoxic reactions, erythema multiforme, erythroderma, DRESS, and SJS/TEN - highlighting classic morphology, timing, red-flag features, and what to do next when you’re the first clinician to see the rash.
This episode reviews hyponatremia through a physiology-first lens, emphasizing that it is primarily a disorder of water balance rather than sodium itself. We discuss how urine sodium helps differentiate hypovolemic, hypervolemic, and euvolemic hyponatremia and why it often provides a more reliable assessment of effective volume status than the physical exam. The episode then focuses on SIADH, explaining how persistent ADH activity limits free water excretion, why salt tablets can worsen hyponatremia by increasing water intake, and how urea offers a more effective osmotic strategy. We also compare the roles and risks of vaptans versus hypertonic saline in acute, symptomatic cases and review the mechanism of “desalination,” where normal saline worsens sodium levels in unrecognized SIADH. The goal is to provide a clear, practical framework for evaluating and managing hyponatremia at the bedside.
This episode breaks down what MGUS truly represents and why it’s so often misunderstood. It explains how a small, silent monoclonal protein fits into the spectrum of plasma cell disorders, why most people with MGUS feel completely well, and what actually drives the risk of progression to myeloma or related conditions. The discussion walks through the essential diagnostic labs, the Mayo Clinic risk model, and how to distinguish harmless MGUS from cases where the protein begins to damage organs. It also explores smoldering myeloma, MGRS, and AL amyloidosis, helping listeners understand when a quiet lab finding becomes clinically significant.
Source:
Monoclonal Gammopathy of Undetermined Significance (Review) from NEJM