Study on prevalence of Frank's sign in cardiac patients in a tertiary care centre, Kanyakumari district

Nivin Simon, Mulamoottil George Varghese, A. J. S. Pravin, M. K. Padmaprasad, S. Rajagopal, M. Vijaya Bharathi, Sushma I.


Background: Despite its identification over 40 years ago, very few dermatologists are aware of the relevance of Frank’s sign as a cutaneous indicator of coronary artery disease. Aim was to find out the prevalence of Frank's sign among cardiac patients attending a tertiary care centre in Kanyakumari district.

Methods: This was a cross-sectional case-control study involving 270 patients, out of which 200 patients with proven CAD (by angiography) and 70 patients without evidence of CAD of more than 40 years of age, in cardiac ward as well as patients attending Cardiology and dermatology OPD in Sree Mookambika Institute of Medical Sciences, kanyakumari during a period of 5 months from August 2020 to December 2020. The data compiled included age, gender, presence of CAD, presence of DELC, grade of DELC, and laterality.

Results: DELC was present in 109 cases (40.3%) out of which 92 cases (34 %) had CAD and in 17 cases (6.3%) were without CAD, which was statistically significant (p<0.05).

Conclusions: There have been very few studies evaluating the frequency of DELC in South Indian patients with CAD. According to results of the present study, DELC was significantly associated with CAD. DELC was an important dermatological indicator of CAD with a moderately high specificity (75%) and positive predictive value (84%), but had a low sensitivity (46%) and negative predictive value (33%).  


Frank's sign, Coronary artery disease, Diagonal earlobe crease

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