Plummer-Vinson syndrome - Oral Mucosal Lesion
Patients typically complain of a burning sensation of the oral mucosa, resulting in intolerance to dentures. Clinical findings include angular cheilitis and marked atrophy of lingual papillae producing a smooth, red appearance. Systemic features include dysphagia due to esophageal webs or strictures, koilonychia, and brittle nails. Fatigue, shortness of breath and weakness are characteristic symptoms of the iron-deficiency anemia.
Risk factors include iron-deficiency anemia in women of Northern European descent. The process evolves slowly and is progressive unless treated.
D50.1 – Sideropenic dysphagia
80126007 – Plummer-Vinson syndrome
Differential Diagnosis & Pitfalls
- Erythematous candidiasis – Candidal glossitis may be caused by broad-spectrum antibiotics ("antibiotic sore mouth") or xerostomia. Culture for Candida albicans is usually positive, but organisms are often sparse on cytologic smears.
- Atrophic glossitis secondary to deficiency of folic acid, vitamin B12 (pernicious anemia) – The oral findings are similar to iron-deficiency anemia and Plummer-Vinson syndrome. Hematological testing followed by replacement therapy is curative.