Kragballe 1991.

Methods	Randomised, open, prospective, right‐left comparative trial Number of centres not stated Period of inclusion not stated
Participants	Inclusion criteria Palmoplantar pustulosis or localised pustular psoriasis with symmetrical lesions (palms, soles, or both) for 0.5 to 40 years Age 18 to 71 years Exclusion criteria Unstable lesions during the 2‐week washout period Systemic antipsoriatic treatment or UV radiation within 2 months before study entry Infected skin lesions Allergy to any of the treatment materials Baseline data: randomised comparison of Actiderm plus triamcinolone acetonide 0.1% cream applied every third day (19) vs clobetasol 0.1% cream applied twice daily (19) Mean age, years: 44 Male/female: 16/3 Mean duration of condition (range), years: 12 (0.5 to 40) Proportion of participants with psoriatic lesions elsewhere: not specified Severity at baseline on each randomised and treated side not specified Withdrawal: no dropouts
Interventions	Intervention 1 A: Actiderm plus triamcinolone acetonide (TAA) 0.1% cream every third day (19 participants) Intervention 2 B: clobetasol 0.05% cream twice per day (19 participants) Co‐interventions: none Duration of treatment: 4 weeks
Outcomes	No primary or secondary outcome pre‐specified Severity of eruption on a 4‐point scale for erythema, scaling, thickness, and pustules Degree of itch Overall response to therapy Presence of skin atrophy Adverse events Outcomes were evaluated at each visit (‐2, 0, 2, 4, and 8 weeks)
Notes	Funding: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "This was a randomised comparison" Comment: insufficient information about the sequence generation process to permit judgement
Allocation concealment (selection bias)	Unclear risk	Comment: no information on method to guarantee allocation concealment
Blinding of participants and personnel (performance bias) All outcomes	High risk	Quote: "Actiderm plus TAA 0.1% cream was replaced every third day. Clobetasol 0.05% cream was applied twice daily" Comment: no evidence of blinding, which is very difficult in this case
Blinding of outcome assessment (detection bias) All outcomes	High risk	Comment: no evidence of blinding
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Comment: no mention of missing data
Selective reporting (reporting bias)	High risk	Comment: no protocol found to guarantee that all planned outcomes are presented in the results and not all outcomes cited in the methods were reported in the results (skin atrophy)