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| IMAGE IN CARDIOLOGY |
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| Year : 2018 | Volume
: 7
| Issue : 3 | Page : 118-119 |
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Frank's sign: Cutaneous marker of cardiovascular disease
Rakesh Agarwal MBBS, MD
Department of Cardiology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
| Date of Web Publication | 10-Jul-2018 |
Correspondence Address:
Dr. Rakesh Agarwal
243, G.T. Road (N), Laxmi Niketan, Flat-2E, Liluah, Howrah - 711 204, West Bengal
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/JCPC.JCPC_3_18
How to cite this article:
Agarwal R. Frank's sign: Cutaneous marker of cardiovascular disease. J Clin Prev Cardiol 2018;7:118-9 |
A 60-year-old man with long-standing hypertension on irregular drug intake presented with right-sided hemiplegia, nausea, and vomiting. Clinical examination was consistent with a left-sided cerebrovascular accident and imaging corroborated the clinical findings. The patient was initially managed in the Intensive Care Unit and later in the ward conservatively. He was noted to have bilateral Frank's sign on general examination [Figure 1], [Figure 2], [Figure 3]. | Figure 3: Computed tomography image showing left basal ganglia hemorrhage
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Frank's sign is described as “a prominent crease in a lobule portion of the auricle.”[1] This diagonal ear lobe crease has been considered to be a cutaneous marker of coronary and carotid atherosclerosis.[2] It is said to be a dermatological indicator of premature aging and loss of dermal and vascular fibers.[3] However, genetics, anatomic peculiarity, or a result of a particular way of sleeping have also been postulated to lead to Frank's sign.[4] In fact, the sign was mentioned by Petrakis in some of the Greco-Roman sculptures in the museums of Rome.[1],[4] Several cases associate Frank's sign with ischemic heart disease and ischemic strokes, but this is probably the first case where it has been noticed in a patient with hypertensive hemorrhagic cerebrovascular event.[3],[5]
Frank's sign should alert the clinicians toward an underlying cardio-cerebrovascular disease, and an evaluation directed at it should be done in patients presenting with the same.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Petrakis NL. Diagonal earlobe creases, type A behavior and the death of Emperor Hadrian. West J Med 1980;132:87-91.  |
| 2. | Friedlander AH, López-López J, Velasco-Ortega E. Diagonal ear lobe crease and atherosclerosis: A review of the medical literature and dental implications. Med Oral Patol Oral Cir Bucal 2012;17:e153-9. |
| 3. | Griffing G. Images in clinical medicine. Frank's sign. N Engl J Med 2014;370:e15. |
| 4. | Guţiu IA, Galeţescu E, Guţiu LI, Răducu L. Diagonal earlobe crease: A coronary risk factor, a genetic marker of coronary heart disease, or a mere wrinkle. Ancient Greco-Roman evidence. Rom J Intern Med 1996;34:271-8. |
| 5. | Fareedy SB, Pathak R, Salman A, Alweis R. Frank's sign: A potential predictor of cardiovascular disease. J Community Hosp Intern Med Perspect 2015;5:26885. |
[Figure 1], [Figure 2], [Figure 3]
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