Gupta 1993.

Methods	Parallel‐group, randomised controlled trial The study was conducted at a single dermatology centre in Canada
Participants	58 participants with steroid‐responsive dermatitis limited to the hands Evaluable: 54 Dropouts: 6, of whom 4 permitted a protocol violation and 2 ended prematurely because of an exacerbation of hand eczema Inclusion criteria of the trial Corticosteroid‐responsive dermatitis limited to the hands Exclusion criteria of the trial Medically significant cutaneous conditions other than hand eczema Clinically infected hand dermatitis Known sensitivity to study medication Use of topical corticosteroids in the last 14 days, other topical treatments in last week, systemic corticosteroids during last 12 weeks. Systemic antimicrobials, all other investigational drugs and radiation therapy last 30 days, systemic or topical antihistamines in last 14 days, and topical anaesthetics or topical and systemic analgesics in last 48 hours Study population Gender: not stated Age: 18 to 70 years
Interventions	Intervention • Betamethasone dipropionate film‐forming lotion in 28/29 participants daily for 7 days • Betamethasone dipropionate thickened lotion in 26/29 participants for 7 days Duration 1 week
Outcomes	Primary outcomes of the trial Not defined Other outcomes Investigator‐rated overall severity of hand eczema:(0 = absent, 1 = mild, 2 = moderate, 3 = severe) at days 2, 4, and 7 Investigator‐rated scores (0 = absent, 1 = mild, 2 = moderate, 3 = severe) of pruritus, scaling, erythema, induration at days 2, 4, and 7 Physician global assessment of eczema relief (+3 = cleared to ‐2 = much worse) at days 2, 4, and 7 Adverse events
Notes	Very short study of only 7 days. Unclear about withdrawals in lotion group. Exact number allocated to each treatment not specified. Among the different outcomes, unclear how change in overall severity was calculated Declarations of interest: not stated. Funding: the study was supported in part by a grant from GenDerm Corporation, Montreal, Canada, manufacturer of the study drugs Sample size rationale: not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "participants were randomly assigned to 2 groups..." Comment: no further details
Allocation concealment (selection bias)	Low risk	Quote: "bottles were dispensed in their marketed containers with identical overlabels and the contents were not known to the patients or the investigator who assessed the results. Only the study coordinator was aware of the contents of the bottles" Comment: sequentially numbered drug containers of identical appearance are considered as adequate allocation concealment
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Quote: "bottles were dispensed in their marketed containers with identically appearing overlabels and the contents were not known to the patients or the investigator who assessed the results. Only the study coordinator was aware of the contents of the bottles" Comment: double‐blind study; identical looking containers were used
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: "bottles were dispensed in their marketed containers with identically appearing overlabels and the contents were not known to the patients or the investigator who assessed the results. Only the study coordinator was aware of the contents of the bottles" Comment: observers were unaware of the study drug, which was identical in appearance
Incomplete outcome data (attrition bias) All outcomes	Low risk	No intention‐to‐treat analysis but per protocol (54 or 52 of 58 = more than 80%)
Selective reporting (reporting bias)	Unclear risk	No trial registration found. No major differences between the Methods and Results sections found; however for erythema and pruritus, study authors state only that no significant differences were found
Other bias	Low risk	Baseline comparisons: at baseline, significant differences in scaling between groups, but controlled for by statistical procedure. No significant differences at baseline with regard to age, gender, race, erythema, induration, pruritus, or area of eczematous involvement Diagnostic certainty: yes The study was completed