Introduction: Desomorphine is an opioid formerly used to treat acute pain. It is simple to manufacture, which has recently led to an increase in its clandestine production under the name “Krokodil”. This article presents a case of oral problems related to its use first ever reported in France. Observation: A 36-year-old male patient presented with bone exposure in sector 1. He admitted to actively consuming “Krokodil IV” for several years. In the course of the clinical and radiological examinations, the patient was diagnosed with osteochemonecrosis of the maxillary induced by krokodil, considering that severe intrinsic and extrinsic adverse effects have been attributed to the drug. Discussion: A systematic literature review was conducted using articles from the Medline and Web of Science databases. To treat such a condition, two authors have described a process consisting of total excision of the necrotic tissue with 0.5 cm margins, combined with discontinuing the intake of the drug. However, these observations should be considered with caution because of the absence of any prospective studies. Conclusion: There are a number of etiologies for osteonecrosis in the context of radiotherapy, intake of bisphosphonates, and administration of bone resorption inhibitors. Unfortunately, in the case of krokodil, its high addictive nature makes it difficult for the patient to wean off the drug. Further, the heterogeneity of its manufacturing make it challenging to pharmacokinetically analyze its prolonged use. In view of the current literature, surgical therapy associated with weaning appears to be the most appropriate treatment, without being able to rule out addiction or necrotic relapses.

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Introduction: Noonan Syndrome is a clinically and genetically heterogeneous syndrome, characterized by marked phenotypic variability. All the clinical manifestations of this syndrome are still not fully known. Observation: We present the case of a 58-year-old woman with a diagnosis of Neurofibromatosis-Noonan syndrome with SOS2 mutation, observed by her general practitioner for a recurrent left upper lip abscess despite drainage and antibiotic therapy. The anatomo-pathological result of the sample was in favor of an infected xanthoma. Discussion: The most common oral manifestation of Noonan syndrome includes malocclusion, dental anomalies and radiologic jaw lesions. Xanthomas of the lip have never been reported in this syndrome. Conclusion: Oral xanthomas could be one of the many oral clinical manifestations of Noonan Syndrome. However, more research is needed to understand clinical consequences of mutations in identified genes.