A study on the prevalence of diagonal earlobe crease in patients with cardiovascular disease and diabetes mellitus

Background: The diagonal ear lobe crease also known as Frank's sign is a diagonal crease in the ear lobe that extends from the tragus across the lobule to the posterior edge of the auricle. There have long been postulates of the association of Frank's sign with cardiovascular disease, diabetes mellitus and there have been studies that have said that Frank's sign is a mark of cardiovascular disease but have not linked it to the severity of the disease. Methods: In our study we aim to assess the prevalence of Frank's sign in individuals with coronary artery disease and evaluate its correlation with its severity while also seeing if the correlation exists with diabetes mellitus, laterality of the sign and hair in the external auditory canal in our setting of a tertiary care hospital amongst a sample of 152 patients with proven ischemic heart disease. Clinical data included age, gender, presence of Diabetes mellitus, severity of IHD as per angiography, grade of Frank's Sign, presence of hair in the canal and laterality of Franks sign. Results: Franks sign was more often seen around the age group of 51 to 70 years and though it was seen more often in the male population this was not a statistically significant correlation. 98 patients with IHD (64.47%) had Franks sign. Of these, 50 (51%) had Diabetes Mellitus. The presence of bilateral Frank's sign was more often associated with IHD and this was seen to be statistically significant. So also, presence of hair in the canal was shown to be having a positive Frank's sign more often than not. While severity of IHD varied almost directly with grade of Frank's sign it was not a statistically significant correlation. Conclusion: Therefore, we may presume that the presence of the DELC correlates to some extent correlate with ischemic cardiovascular disease it does more so when bilateral. Though many patients also have diabetes mellitus, the co-existence was not found to have statistical significance and larger studies will be required to prove its usefulness in this regard.