This multicenter, randomized, double-blind clinical trial involving 89 subjects (86 with chronic hand dermatitis and 3 with atopic dermatitis) compared the safety, efficacy, and cosmetic acceptability of 4 medium-potency topical corticosteroid products: hydrocortisone butyrate (HB) 0.1% cream (Locoid Lipocream), fluticasone propionate (FP) 0.05% cream (Cutivate), prednicarbate (PC) 0.1% cream (Dermatop), and mometasone furoate (MF) 0.1% cream (Elocon). Subjects were randomly assigned to 1 of 3 treatment groups (HB vs FP, HB vs PC, or HB vs MF) and further randomized to HB on the right or the left side, and FP, PC, or MF on the contralateral side. Treatments were self-administered twice daily for 2 weeks. Assessments of efficacy were based on the investigator ratings of signs and the subject ratings of signs and symptoms. Cosmetic acceptability was assessed by direct comparisons between products using a subject questionnaire. The results indicated comparable efficacy of all 4 medium-potency corticosteroid products and suggested that, compared to other corticosteroid creams, the HB vehicle yielded somewhat greater subject preference with respect to cosmetic appeal.