Our current Author Spotlight features Mark G. Lebwohl MD, who co-authored the article titled, “Resolving Hyperkeratotic Psoriasis: Mechanisms of Action and Additive Effects of Fixed-Combination Halobetasol Propionate and Tazarotene” published in JDD’s August issue. In addition to the article, JDD asked Dr. Lebwohl some questions related to dermatology in order to provide some deeper insight to our readership on the author behind the article.

In your experience, what is one commonly overlooked factor in diagnosing or managing a specific skin condition that you think deserves more attention?

Combination therapy is often superior to monotherapy with single agents. The mistake that is made is ad hoc mixing of two different therapies that haven’t been tested together. First, by mixing equal volumes of two agents, you are reducing the concentration of each active ingredient by half. Second, you don’t know for certain that the two vehicles or actives being mixed are compatible with one another. There are many examples of one active inactivating another. For example, calcipotriene is notoriously susceptible to degradation in an acid pH.

Of all your research findings, are there any surprising or unexpected results that changed your perspective on the topic?

Additive or synergistic effects are hoped for and often achieved. A side benefit that could have been predicted is the reduction in irritation of tazarotene by combining it with halobetasol.

How do you navigate the challenge of balancing efficacy and accessibility when recommending treatments to patients from diverse backgrounds?

Prescribing optimal therapies distinguishes the best physicians from their colleagues. Once you figure out that discount pharmacies make better, more expensive therapies available at reasonable prices, use of those pharmacies allows you to prescribe more effective medicines and reduces callbacks from patients who blame us for the cost of the therapies we prescribe.