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Topical Treatments:

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Emollients and keratolytics

Emollients and keratolytics play an adjunctive role in the topical management of psoriasis. Emollients and moisturizers are essential to normalize epidermal hyperproliferation and differentiation, improve the barrier function and stratum corneum hydration, making the epidermis supple and strong enough to prevent Koebnerization from trauma or stress.

They are especially supportive in scaly plaque lesions and in maintenance of remission of psoriasis. Emollients like clear mineral oil penetrates the intercellular spaces allowing an optical matching effect, which increases the UV transmission and hence therapeutic effect of UVB phototherapy.  Mild emollient such as petrolatum is suitable for children of all ages.

In older children, and adults emollients with keratolytics can be considered. Salicylic alone as 3% and 6% ointment or shampoo is beneficial for softening small, thick, localized scaly plaques on the scalp, palms and soles in psoriasis patients. However, it should be avoided in children under 6 years especially infants because of risk of percutaneous salicylate intoxication.