Faghihi 2008.

Methods	Within‐participant, randomised controlled trial This study was conducted in a secondary setting at 2 different centres in Iran
Participants	47 participants with nearly symmetrical chronic hand eczema with a duration > 4 weeks No dropouts Inclusion criteria of the trial Symmetrical chronic hand eczema with duration > 4 weeks Older than 12 years of age Exclusion criteria of the trial Pregnancy No topical treatment during the last 2 weeks nor systemic medication treatment in the last month Systemic illness Study population Gender: 35 female, 12 male Age: range 17 to 74 years
Interventions	Intervention • 0.05% clobetasol + 2.5% zinc sulphate cream on 1 hand in 47 participants for 2 weeks • 0.05% clobetasol cream alone on the other hand in 47 participants for 2 weeks Duration 2 weeks
Outcomes	Primary outcomes of the trial Not defined Other outcomes Assessment and scoring of different characteristics of hand eczema, namely, scaling, erythema, lichenification, and itch, on a 3‐point scale Severity of itching evaluated by means of the visual analogue scale (VAS) Adverse events
Notes	Overall severity of hand eczema was not an outcome. Use of the Mann‐Whitney U‐test for statistical analysis appears incorrect, as the data were related (within‐subject design) The secondary outcomes ‐ reduction in severity, participant‐rated, and time until relapse ‐ were included but did not provide reproducible data Study authors were contacted by mail on 28 February 2014 but remained unresponsive Declarations of interest: not stated Funding: the study was funded and supported by Isfahan University of Medical Sciences Sample size rationale: not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "... right or left hand of them were randomised to be treated..." Comment: no further details given
Allocation concealment (selection bias)	Unclear risk	No details about how allocation was concealed from participants and investigators
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Quote: "the patients and investigators were blinded to type of treatment" Comment: the drugs were made in "similar shape" by a third party; this is considered an adequate way to blind participants Quote: "drugs were made by the Isfahan Pharmacy School in the similar shape, and the patients and investigators were blinded to the type of treatment" Comment: the code of drugs was revealed only at the end of the study
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Quote: "drugs were made by the Isfahan Pharmacy School in the similar shape, and the patients and investigators were blinded to the type of treatment. The code of drugs was revealed only at the end of the study" Comment: no details regarding blinding of outcome assessors, although study authors mention a double‐blind design; this is insufficient information to judge the risk of bias
Incomplete outcome data (attrition bias) All outcomes	Low risk	Quote: "overall, 47 patients (94 samples) were evaluated and all of them completed the study" Comment: all participants completed the study and were included in the analyses
Selective reporting (reporting bias)	Unclear risk	No trial registration found. All outcomes described in Subjects and Methods are described in the Results section, although for itch, only the statistical significance level is stated, but the other outcomes are stated in tables with exact numbers
Other bias	Low risk	Baseline comparisons revealed no significant differences between groups in terms of erythema, scaling, lichenification, and pruritus; further within‐participant design Diagnostic certainty: yes The study was completed