The Earlobe Crease
by Richard Strongwater, MD
Frank’s SignIn BriefEarlobe Creaseby Richard Strongwater, MDFrank's sign is defined as a deep wrinkle orcrease (usually single or double on the sameearlobe) that extends diagonally from thetragus toward the posterior border of theearlobe.
It may occur unilaterally or bilaterally. Earlobecrease (ELC) sign has been associated with anincreased risk for coronary artery disease(CAD). The prevalence of ELC increases withage and in patients with CAD. ELC and CADmay be associated with the loss of elastin andelastic fiber in skin and arteries. Many studiessupport the association of CAD with ELC.Presence of a persistent earlobe crease should prompt careful assessment of thepatient's risk factors for heart disease and
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Kirkham N, Murrells T, Melcher DH, Morrison EA. Diagonal earlobe creases and fatalcardiovascular disease: a necropsy study.Brit HeartJ.1989;61:361–364.
Gulsin GS, Clement KD, Anglim N. Frank’s sign as a marker of coronary arteryatherosclerosis.J Cardiol Clin Res.2014;2:1032.
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