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Case Reports
. 2019 Mar 11;11(3):e4219.
doi: 10.7759/cureus.4219.

Diagonal Earlobe Crease, a Marker of Coronary Artery Disease: A Case Report on Frank's Sign

Araz Baboujian  1 , Prema Bezwada  1 , Cesar Ayala-Rodriguez  1
Affiliations
Case Reports

Diagonal Earlobe Crease, a Marker of Coronary Artery Disease: A Case Report on Frank's Sign

Araz Baboujian et al. Cureus. .

Abstract

There are various physical signs that can be used as a reliable tool to diagnose the subclinical stages of atherosclerosis, including corneal arcus, xanthelasma, and diagonal earlobe crease (DELC) or "Frank's sign". Bilateral diagonal earlobe crease has been positively correlated with coronary artery disease (CAD) and peripheral vascular disease (PVD). The presence of DELC has been identified as an independent variable for CAD. The exact etiology is unknown and the association between the presence of DELC and coronary artery disease (CAD) still remains controversial. We report a case of a patient with bilateral DELC who was found to have remarkable non-occlusive CAD on diagnostic coronary angiography.

Keywords: case report; coronary atery disease; diagonal earlobe crease; frank sign; peripheral vascular disease; physical examination.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Bilateral diagonal earlobe creases as indicated by arrows
Figure 2
Figure 2. Coronary angiogram
Panels A and B: Coronary angiogram showing disease of the circumflex artery - 30% lesion in the proximal segment (arrow 1), a 50% lesion in the distal segment (arrow 2), and a 50% lesion in the proximal segment of the obtuse marginal artery (arrow 3).
See this image and copyright information in PMC

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