Iron deficiency (ferropenic) anemia produces an atrophy of the mucosal tissues, especially the dorsal side of the tongue which is denuded of papillae, giving a smooth, shiny and reddish aspect to the tongue.  When combined with dysphagia one talks about Paterson-Kelly or Plumber-Vison Syndrome.  Malnourished and elderly patients, as well as females, are the most affected.  The patient presents with pain and a burning sensation principally of the tongue, making it many times difficult to eat.  The clinical case is sometimes complicated by an overlying candida infection. 

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