Dreno 2003

Methods	Individual randomised controlled trials
Participants	Dx: facial seborrhoeic dermatitis of at least 2 months' duration in male and female patients between 18 and 65 years of age; moderate to severe redness and scaling. Physician diagnosis implied from context Exclude patients with allergy to test products; patients with scalp SD requiring therapy; patients with Parkinson's disease, HIV, ear, nose and throat cancer, and with severe recurrent illness Sex: lithium (male - 63.8%), keto (male - 63.2%); age: lithium (39.2 ± 11.7), keto (41.3 ± 11.2); duration: lithium (3.5 ± 1.0 years), keto (3.6 ± 0.9 years); previous treatment: lithium (75%), keto (72.8%)
Interventions	Int: Lithium gluconate 8% applied twice daily for 8 weeks (n = 152) Control: ketoconazole 2% emulsion applied twice weekly to face for 28 days and then once weekly for the next 28 days (n = 136)
Outcomes	Complete remission of rashes Percentage clearance of redness, itching and scaling
Notes	Country: France; COI: sponsorship by Laboratoire Labcatal, producer of the brand of lithium gluconate used Sample size derivation was elucidated; compliance with regimen was also a study objective; side effects: lithium (26.3%), keto (25%)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"The randomization method used computer generated blocks .."
Allocation concealment (selection bias)	Low risk	"The randomization code was concealed in sealed envelopes ..."
Baseline comparable?	Low risk	See Table 1
Patient blinded?	Low risk	"Investigators provided patients with sealed boxes ... these boxes were similar in appearance ..."
Provider blinded?	Low risk	"Investigators provided patients with sealed boxes ... these boxes were similar in appearance ..."
Outcome assessor blinded?	Low risk	"The randomization code was concealed in sealed envelopes ..."
Co-interventions avoided?	Unclear risk	Not reported
Compliance acceptable?	Low risk	80% compliance with protocol: lithium (93.3%), keto (93%)
Drop-out acceptable?	Low risk	Lithium (17/152), keto (17/136)
Selective outcome reporting acceptable?	Low risk	All outcomes were reported
ITT?	Low risk	Number of participants evaluated corresponds with the number randomly assigned. Refer to Figures 4, 5 and 6