Franks Sign
Other Names
- Frank's sign
- Franks sign
- Diagonal earlobe crease sign
- Earlobe crease sign
- Diagonal lobular crease
- Diagonal earlobe wrinkle
- Earlobe crease of coronary artery disease
- CAD earlobe sign
Purpose
- Serve as a clinical clue to increased cardiovascular risk during physical examination
- Prompt further cardiovascular risk assessment when present, especially in younger patients or when bilateral
- First described in 1973 by American physician Sanders T. Frank
Description
- Visible diagonal crease of the earlobe extending from the tragus to the posterior-inferior edge
- Typically oriented at approximately 45 degrees
- May be unilateral or bilateral, with bilateral findings carrying stronger associations
- Considered non-diagnostic and should be interpreted alongside other clinical findings and risk factors
Pathology
- Coronary Artery Disease
- Atherosclerosis
- Cerebrovascular Events
Evidence
Cerebrovascular Events
- Nazal et al[3]
- 78.8% of acute stroke patients
- 88.6% of those with cerebrovascular accidents
Coronary Artery Disease
- Jo et al[4]
- Sensitivity: 26-90%
- Specificity: 32-96%
See Also
References
- ↑ Elawad, Omer Ali Mohamed Ahmed, and Ahmed Abdalazim Dafallah Albashir. "Frank’s sign: dermatological marker for coronary artery disease." Oxford Medical Case Reports 2021.9 (2021): omab089.
- ↑ Lin, Aung Naing, et al. "A myth still needs to be clarified: A case report of the Frank's sign." Cureus 10.1 (2018).
- ↑ Nazzal, Saleh, et al. "Diagonal earlobe crease (Frank's sign): a predictor of cerebral vascular events." The American Journal of Medicine 130.11 (2017): 1324-e1.
- ↑ Jo, Sungman, Joon Hyuk Park, and Ki Woong Kim. "Frank’s Sign as a Dose-Dependent Marker of White Matter Burden in CADASIL: A Brain MRI Study." Journal of Clinical Medicine 14.19 (2025): 6865.
Created by:
John Kiel on 22 January 2026 01:21:24
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Last edited:
22 January 2026 02:37:22
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