Necrotic Lesions Associated with Desomorphine ("Krokodil") Drug Abuse: a Systematic Review

Objectives: This systematic review of case reports and case series aims to identify the types of necrotic alterations caused by desomorphine ("Krokodil") and the diagnostic methods used in such cases. Material and Methods: An advanced search was conducted on 30 January 2025 in the Web o...

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Main Authors: Elitsa Sabeva, Dimitar Dochev
Format: Article
Language:English
Published: Lithuanian University of Health Sciences, Faculty of Odontology 2025-03-01
Series:eJournal of Oral Maxillofacial Research
Subjects:
Online Access:https://www.ejomr.org/JOMR/archives/2025/1/e1/v16n1e1ht.htm
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author Elitsa Sabeva
Dimitar Dochev
author_facet Elitsa Sabeva
Dimitar Dochev
author_sort Elitsa Sabeva
collection DOAJ
description Objectives: This systematic review of case reports and case series aims to identify the types of necrotic alterations caused by desomorphine ("Krokodil") and the diagnostic methods used in such cases. Material and Methods: An advanced search was conducted on 30 January 2025 in the Web of Science, Scopus, and PubMed databases using the selected keywords and MeSH terms. The research was conducted in accordance with the PRISMA guidelines. A total of 54 records were identified and screened for eligibility. After meticulous evaluation by two independent reviews, 15 articles were included in this systematic review. Results: Of the included 251 cases, 247 discussed osteonecrosis of the facial bones. Three out of the four cases discussing limb necrosis presented a high risk of bias. The most commonly used paraclinical diagnostic methods were: radiological examination (radiographs, cone-beam computed tomography, etc.), histopathological examination, microbiological tests, and blood tests. Other less common methods included scintigraphy and C-terminal telopeptide tests. This systematic review did not identify enough cases discussing desomorphine-associated skin lesions. Conclusions: Desomorphine ("Krokodil") is a dangerous drug that causes different local and systemic damages, including soft-tissue lesions and bone necrosis. Future studies should focus on the distribution of the necrotic lesions according to the affected tissues/organs, and the possible correlation between the drug use period and the clinical findings.
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spelling doaj-art-b81b901b60fb43e39f6be393bfe212df2025-08-20T03:35:54ZengLithuanian University of Health Sciences, Faculty of OdontologyeJournal of Oral Maxillofacial Research2029-283X2025-03-01161e110.5037/jomr.2025.16101Necrotic Lesions Associated with Desomorphine ("Krokodil") Drug Abuse: a Systematic ReviewElitsa SabevaDimitar DochevObjectives: This systematic review of case reports and case series aims to identify the types of necrotic alterations caused by desomorphine ("Krokodil") and the diagnostic methods used in such cases. Material and Methods: An advanced search was conducted on 30 January 2025 in the Web of Science, Scopus, and PubMed databases using the selected keywords and MeSH terms. The research was conducted in accordance with the PRISMA guidelines. A total of 54 records were identified and screened for eligibility. After meticulous evaluation by two independent reviews, 15 articles were included in this systematic review. Results: Of the included 251 cases, 247 discussed osteonecrosis of the facial bones. Three out of the four cases discussing limb necrosis presented a high risk of bias. The most commonly used paraclinical diagnostic methods were: radiological examination (radiographs, cone-beam computed tomography, etc.), histopathological examination, microbiological tests, and blood tests. Other less common methods included scintigraphy and C-terminal telopeptide tests. This systematic review did not identify enough cases discussing desomorphine-associated skin lesions. Conclusions: Desomorphine ("Krokodil") is a dangerous drug that causes different local and systemic damages, including soft-tissue lesions and bone necrosis. Future studies should focus on the distribution of the necrotic lesions according to the affected tissues/organs, and the possible correlation between the drug use period and the clinical findings.https://www.ejomr.org/JOMR/archives/2025/1/e1/v16n1e1ht.htmdesomorphinekrokodilnecrosisulcers
spellingShingle Elitsa Sabeva
Dimitar Dochev
Necrotic Lesions Associated with Desomorphine ("Krokodil") Drug Abuse: a Systematic Review
eJournal of Oral Maxillofacial Research
desomorphine
krokodil
necrosis
ulcers
title Necrotic Lesions Associated with Desomorphine ("Krokodil") Drug Abuse: a Systematic Review
title_full Necrotic Lesions Associated with Desomorphine ("Krokodil") Drug Abuse: a Systematic Review
title_fullStr Necrotic Lesions Associated with Desomorphine ("Krokodil") Drug Abuse: a Systematic Review
title_full_unstemmed Necrotic Lesions Associated with Desomorphine ("Krokodil") Drug Abuse: a Systematic Review
title_short Necrotic Lesions Associated with Desomorphine ("Krokodil") Drug Abuse: a Systematic Review
title_sort necrotic lesions associated with desomorphine krokodil drug abuse a systematic review
topic desomorphine
krokodil
necrosis
ulcers
url https://www.ejomr.org/JOMR/archives/2025/1/e1/v16n1e1ht.htm
work_keys_str_mv AT elitsasabeva necroticlesionsassociatedwithdesomorphinekrokodildrugabuseasystematicreview
AT dimitardochev necroticlesionsassociatedwithdesomorphinekrokodildrugabuseasystematicreview