Frank's sign

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Normal Ear Anatomy
Earlobe creases seen in a Japanese angina patient

Frank's sign is a diagonal crease in the ear lobe extending from the tragus across the lobule to the rear edge of the auricle.[1] The sign is named after Sanders T. Frank MD.[1]

It has been hypothesised that Frank's sign is indicative of cardiovascular disease[2][3] and/or diabetes.[4] Some studies have described Frank's sign as a marker of cardiovascular disease but not linked to the severity of the condition.[5] In contrast, other studies have rebutted any association between Frank's sign and coronary artery disease in diabetics.[6] There have also been reported cases of Frank's sign assisting in the diagnosis of cerebral infarctions.[citation needed] A link between Frank's sign and premature aging and the loss of dermal and vascular fibers has also been hypothesized.[7] Some studies have focused upon bilateral ELC.[8]


Notable individuals with Franks' sign[citation needed][edit]


  1. ^ a b Frank ST (August 1973). "Aural sign of coronary-artery disease". N. Engl. J. Med. 289 (6): 327–8. doi:10.1056/NEJM197308092890622. PMID 4718047.
  2. ^ Mallinson, Tom; Brooke, David (2017). "Frank's Sign as a clinical marker of cardiovascular disease". Journal of Paramedic Practice. 9 (1): 8-10. doi:10.12968/jpar.2017.9.1.8.
  3. ^ Miot, H.A., Molina de Medeiros, M. etal (2006). Association between coronary artery disease and the diagonal earlobe an preauricular creases in men. Anais Brasileiros de Dermatologia. vol.81 no.1
  4. ^ Mustafa Ahmed, M.D. (13 August 2014). "Earlobe Crease And Heart Disease – Fact Or Myth?". Abel Healthcare. Retrieved 8 February 2015.
  5. ^ Lesbre JP, Castier B, Tribouilloy C, Labeille B, Isorni C (January 1987). "[Frank's sign and coronary disease]". Ann Cardiol Angeiol (Paris) (in French). 36 (1): 37–41. PMID 3827155.
  6. ^ Davis TM, Balme M, Jackson D, Stuccio G, Bruce DG (October 2000). "The diagonal ear lobe crease (Frank's sign) is not associated with coronary artery disease or retinopathy in type 2 diabetes: the Fremantle Diabetes Study". Aust N Z J Med. 30 (5): 573–7. doi:10.1111/j.1445-5994.2000.tb00858.x. PMID 11108067.
  7. ^ George Griffing, M.D. (March 2014). "Frank's Sign". The New England Journal of Medicine. 370 (15). doi:10.1056/NEJMicm1213868.
  8. ^ Evrengül H, Dursunoğlu D, Kaftan A, et al. (2004). "Bilateral diagonal earlobe crease and coronary artery disease: a significant association". Dermatology. 209 (4): 271–5. doi:10.1159/000080847. PMID 15539887.
  9. ^ Livingston, David (November 29, 2018). "Dick Van Dyke (age 92), Premiere Of Disney's 'Mary Poppins Returns' - Arrivals". Getty Images. Retrieved November 30, 2018.