Bald tongue and Koilonychia - Funny Fingernails

# A 48 year old female patient walks into your office. She states that she is diagnosed with some disease which she can't remember the name of. Her physician wants her to follow up with you, her dentist, regularly to watch out for cancer of the tongue and throat. She also has a bald tongue, and states that her fingernails "look funny." What disease does she have?
A. Aplastic anemia
B. Plummer-Vinson syndrome
C. Pernicious anemia
D. Cushing's syndrome

The correct answer is B. Plummer Vinson Syndrome.

Plummer-Vinson syndrome characterized by iron-deficiency anemia, atrophic changes in the buccal, glossopharyngeal, and esophageal mucous membranes, koilonychia (spoon-shaped fingernails), and dysphagia. The dysphagia is due to an esophageal stricture or web. SCC of the tongue and throat are complications. It is most common in middle-aged women, rarely in the male. The etiology is unknown. 

Because of the predisposition to the development of carcinoma of the oral mucous membranes, it is essential that the diagnosis be established early so that treatment can be given ASAP. This includes the administration of iron, vitamin B complex and a high protein diet.