Frank's Sign, The Earlobe Crease

Understanding Frank's Sign and Its Link to Heart Disease

InBrief

by Richard Strongwater, MD

Frank's sign is defined as a deep wrinkle or crease (usually single or double on the same earlobe) that extends diagonally from the tragus toward the posterior border of the earlobe.

It may occur unilaterally or bilaterally. Earlobe crease (ELC) sign has been associated with an increased risk for coronary artery disease (CAD). The prevalence of ELC increases with age and in patients with CAD. ELC and CAD may be associated with the loss of elastin and elastic fiber in skin and arteries. Many studies support the association of CAD with ELC.

The presence of a persistent earlobe crease should prompt careful assessment of the patient's risk factors for heart disease and stroke.

References

• 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.