Frank sign-  Diagonal ear lobe crease (DELC) sign     The Frank's sign is a diagonal crease in the earlobe that runs backward from the tragus at a 45-degree angle across the lobule to the rear edge of the auricle and may be a predictor of coronary artery disease.    Frank sign is indicative of coronary artery disease (CAD).  Frank's sign is thought to indicate premature aging and loss of dermal and vascular elastic fibers.   Although it has limited sensitivity, the sign is more useful diagnostically in persons younger than 60 years of age  than in older persons.  Sensitivity  of 43% and specificity of 70%  Pathophysiology: Microvascular  disease of ear lobe which is end artery territory    Grading  system for severity of CAD                    • Unilateral incomplete – least severe                • Unilateral complete                • Bilateral complete – ...
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