In the early 2000’s, one of my medical students taught me about the “Frank’s sign”. Her father was a cardiologist and she said “if you see a crease, it may mean heart disease.” Now I look for it in every one I meet. My father had one. He died of a massive coronary thrombus.
Is it definitive? No. But many clinicians swear by it.
Frank’s sign could be a very simple predictor of heart disease. The diagonal crease in one’s earlobe may hint to underlying atherosclerosis.
The more extensive the crease, the higher the “grade” of the crease where a small wrinkling (Grade 1) is less ominous than a deep crease along the whole earlobe (Grade 3). The image above appears to have both a Grade 1 and Grade 3.
In 1973, Dr. Sanders T. Frank first described it in patients with coronary artery disease.
Subsequent studies found a relationship as well to diagonal earlobe crease (DELC) and heart disease. One study even utilized CT angiography to document the relationship, (Shmilovich, et al. .Relation of diagonal ear lobe crease to the presence, extent, and severity of coronary artery disease determined by coronary computed tomography angiography. Am J Cardiol).
Multiple theories suggest why the earlobe creases if one has heart disease.
- Those with atherosclerois may have poor vascularization (blood flow), so distal body parts such as earlobes may crease when they don’t have the hydration and vascularization as other ears do.
- Collagen and elastic fibers may lose their elasticity from poor vascularization.
- Many times the body expresses a sign dermatologically when pathological processes are beneath the skin. Frank’s sign could be one of the many dermatological manifestations of internal disease like acanthosis nigracans.
Again, the diagonal earlobe crease does not necessarily mean one has heart disease. However it may not hurt to be evaluated for cardiac risk factors such as high cholesterol, hypertension, diabetes etc. as many studies hint to its cardiac relationship.