Nilforoushzadeh 2014a

Methods	Study design: prospective randomised controlled trial Setting/location: Central Research Center of Skin Diseases and Leishmaniasis and Novin Laser Center; Isfahan, Iran Study period: June 2010 to September 2011 (15 months) Sample size calculation: sample size was calculated as 60 cases in each group with further rate of 10% dropouts and exclusions
Participants	Type of Leishmania: not described Inclusion criteria: leishmaniasis scar diagnosed clinically on participants by a dermatologist Exclusion criteria: pregnancy, lactation, colloid scar, treatment with immune system inhibitors, use of isotretinoin or fillers for the past 6 months, use of dermabrasion or skin resurfacing for the past 12 months, skin types of IV to V1 N randomised: 120 (60 people in case group and 60 in control group) Withdrawals: not described N assessed: not described Mean (SD) age: 27.21 years (11.52) (range 6‐45) Sex (male/female): 51%/49% Baseline imbalances: none Severity of illness: mean (SD) scar size: laser CO₂ group: 2.3 cm (0.3) and fractional CO₂ laser: 3.4 cm (0.4)
Interventions	Type of interventions: Group 1: ablative CO₂ laser after applying the topical anaesthetic on scar site with pulsed CO₂, duration: 10 ns, frequency: use of 20 kHz, and power: 25 Kw for one session. The participants were visited at the beginning of the treatment and after 3 and 6 months. Final evaluation was done in the 6th month. Group 2: fractional laser in each session by energy: 25, one pulse, pass: 1, dot cycle: 6, with the system of Qray FRX, Dosis M and M
Outcomes	Clinical response, according to standard quartile grading: 0 < 25% (mild improvement) 25% < score 1 < 50% (moderate improvement) 50% < score 2 < 75% (good improvement) < 75% (very good improvement) The quantitative 4‐point scale used included: 0 = unchanged size 1 = the scar size became a bit small 2 = the scar size became very small 3 = the scar is almost removed Time points reported: 6 months
Notes	Study funding sources: Isfahan University of Medical Sciences Possible conflicts of interest: none declared
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Comment: insufficient detail was reported about the method used to generate the allocation sequence.
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding of participants and personnel (performance bias) All outcomes	High risk	Open trial
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quotes: "A photo was taken from patients before and after treatment with a digital camera ... Evaluation of participants were done by 2 physicians who were not aware of the treatment group. These 2 physicians did the evaluations separately. The reduction in this size of ulcer and the scar was compared with the same lesion"
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Not reported
Selective reporting (reporting bias)	Unclear risk	Protocol not available
Other bias	Unclear risk	There was not enough information in the publication to assess if there were other biases present.