Acute generalized exanthematous pustulosis with mephenesin balm.

Mephenesin is an aromatic glycerol ether which decreases polysynaptic transmission in the spinal cord and brain stem. It is used as a skeletal muscle relaxant in the treatment of multiple sclerosis, Parkinson’s disease or acute muscle strain [1,2]. Mephenesin is associated to methyl nicotinate in the Décontractyl Balm. The methyl nicotinate has a rubifacient effect. Usually, the Décontractyl Balm is well tolerated and associated with local cutaneous reactions. The presence of terpenic products in this balm may cause general side effects such as convulsions or confusions. Acute generalized exanthematous pustulosis (AGEP) is exceptional with this balm. We report a case of AGEP induced by topical application of Décontractyl Balm. This case was notified to the National Centre of Pharmacovigilance of Tunis on the 10th of June 2012.