A middle-aged woman, who complained of a fingernail dystrophy, was found to have the Plummer-Vinson syndrome. In view of the increased incidence of upper respiratory and upper gastrointestinal tract carcinoma, close and prolonged observation of such cases is mandatory. Therapy and the factors which may prevent complete and prompt resolution of the syndrome are considered. The dermatologist must be aware of the signs and symptoms of the Plummer-Vinson syndrome and its systemic implications.