To make sure you are suitable to take part, you will have some screening tests done:

• A blood sample
• Details of your medical history and current medications
• Examination of your hands
• Women capable of having children will be asked to use a reliable form of effective contraception and follow a strict pregnancy prevention program (see participant information sheet for further details)

If the blood test shows that it is not suitable or safe for you to take part in this study, your doctor will discuss other treatment options with you.

• Examination of your hands
• Blood sample
• Urine pregnancy test for women capable of having children
• Complete questionnaires about your hands and your health in general
• You will be randomised to either receive Alitretinoin or PUVA therapy. This is decided at random by a special computer
• Complete a medication diary

• If randomised to Alitretinoin, you will need to take the tablets once a day with the main meal as instructed by your study doctor for 12 weeks
• If randomised to PUVA you will attend the phototherapy clinic twice weekly for PUVA treatment for 12 weeks
• Questionnaires and examination of your hands every 4 weeks

Depending on how your hand eczema is responding to either treatment, you may be asked to continue treatment for up to a further 12 weeks.

• Questionnaires and examination of your hands every 4 weeks until week 36, then once every 8 weeks until you have been in the study for a total of 52 weeks (1 year)

If, after the first 12 or 24 weeks, your randomised treatment is not helping your condition, then your doctor will stop this treatment and treat you according to local standard practice.

Here is a summary of the visits that you will need to attend whilst on the trial: