Supplementary Material for: Homoeopathic Management of a Lower Leg Ulcer with Cellulitis: An Evidence-Based Case Report

Background: Cellulitis is an acute bacterial infection involving the dermis and subcutaneous tissue, characterized by erythema, warmth, swelling, and pain. It commonly follows disruption of skin integrity and may progress to ulceration. Leg ulcers are chronic or acute breaches in skin continuity of the lower limb, frequently associated with infection, inflammation, delayed healing, and significant morbidity. When cellulitis complicates a leg ulcer, the risk of tissue damage and prolonged recovery increases. Although antibiotics constitute standard management, integrative approaches are increasingly explored to support wound healing and reduce complications. Case Presentation: A female patient presented with a painful ulcer on the left lower leg that had evolved from a pimple-like lesion. Clinical examination revealed diffuse erythema, oedema, warmth, tenderness, and ulceration consistent with cellulitis. No systemic complications were noted at presentation. An individualized homoeopathic treatment strategy was adopted based on clinical assessment. Pyrogenium, Calendula officinalis, and Myristica sebifera were prescribed sequentially according to symptom evolution. Supportive management included antiseptic wound cleansing, maintenance of dryness, and topical application of Calendula officinalis ointment. Serial photographic documentation was performed to monitor progression. Results: Progressive reduction in pain, inflammation, and ulcer dimensions was observed during follow-up, with satisfactory wound healing and no reported adverse events. Causality assessment using the Modified Naranjo Criteria for Homoeopathy (MONARCH) yielded a positive attribution score, suggesting a possible relationship between the intervention and clinical improvement. Conclusion: This case highlights favourable clinical evolution of lower leg ulcer with cellulitis managed with individualized homoeopathy alongside wound care, warranting further controlled investigation.