Summary of findings 4. Topical calcineurin inhibitors: tacrolimus 0.1% ointment compared to mometasone furoate ointment for vesicular hand eczema.

Topical calcineurin inhibitors: tacrolimus 0.1% ointment compared to mometasone furoate ointment for vesicular hand eczema
Patient or population: people with moderate to severe chronic relapsing dyshidrotic eczema on hands Setting: secondary care setting at a single dermatology department in Germany Intervention: topical calcineurin inhibitors tacrolimus 0.1% ointment twice daily during 4 weeks Comparison: topical corticosteroid mometasone furoate ointment twice daily during 4 weeks
Outcomes	Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Risk with mometasone furoate ointment	Risk with topical calcineurin inhibitor tacrolimus 0.1% ointment
Primary: investigator‐rated good/excellent control of symptoms ‐ Not measured	See comment	See comment	Not estimable	‐	See comment	Not measured
Primary: participant‐rated good/excellent control of symptoms ‐ Not measured	See comment	See comment	Not estimable	‐	See comment	Not measured
Primary: adverse events Follow‐up: 2 weeks	See comment	See comment	Not estimable	16 pairs of hands (1 RCT)	⊕⊕⊕⊝ Moderatea	Within‐participant design None of the participants dropped out because of adverse events
Secondary: investigator‐rated reduction in severity ‐ DASIb Follow‐up: 2 weeks	See comment	See comment	Not estimable	16 pairs of hands (1 RCT)	⊕⊕⊕⊝ Moderatea	Within‐participant design Tacrolimus group: Mean DASI from 18 (SD 12.68) to 6.6 (SD 6.18) Mometasone furoate group: Mean DASI from 18.5 (SD 14.09) to 6.9 (SD 7.7)
*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; DASI: Dyshydrotic Eczema Area and Severity Index; RCT: randomised controlled trial; RR: risk ratio; SD: standard deviation. Schnopp 2002
GRADE Working Group grades of evidence. High certainty: further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty: we are very uncertain about the estimate.

^aDowngraded by one level to moderate‐certainty evidence for imprecision: small sample size in a single study and small number of events.

^bDASI: Dyshydrotic Eczema Area and Severity Index is an assessment of severity combining objective (vesicles, erythema, and desquamation) and subjective (itch) evaluations on a scale from 0 (no eczema) to 60 (severe hand eczema).