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Earlobe Crease Now Linked to Stroke Risk

Previously suggested to be linked to heart disease, a crease in the earlobe, or “Frank’s sign” has now also been linked to stroke.

Israeli researchers reviewed the records of 241 people who had suffered a stroke and 78.8% of them had Frank’s Sign.

Nazzal et al wrote, “Frank sign could predict ischemic cerebrovascular events. Patients with classical cardiovascular risk factors had Frank sign in a higher frequency.”

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).

If Frank’s sign predicts heart disease, it would make sense that it could also predict stroke risk.  The diagonal crease in one’s earlobe may hint to underlying atherosclerosis. The vessel damage and cholesterol plaques can affect blood flow to the brain. Hence, both conditions share similar risks.

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.

Multiple theories suggest why the earlobe creases if one has heart disease or stroke risk.

  1.  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.
  2. Collagen and elastic fibers may lose their elasticity from poor vascularization.
  3. 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.

Famous people known to have Frank’s sign include President George W. Bush, Mel Gibson, Steven Spielberg.

Mel_Gibson-HEBREW ELF.jpg

Again, the diagonal earlobe crease does not necessarily mean one has heart disease or will suffer a stroke.  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 cardiovascular relationship.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and Board Certified Family Physician



Nationally Syndicated Radio Host, Board Certified Family Medicine Physician, Author

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