To evaluate whether a significant statistical correlation exists between earlobe crease (EC) and coronary heart disease (CHD), 1000 Japanese adult patients (573 males, 427 females) were examined for the presence or absence of EC, clinical or angiographic evidence of CHD, and the following coronary risk factors: male sex, age over 50 years, obesity, hypertension, diabetes mellitus, cigarette smoking, and hyperlipidemia. Patients were divided into two groups according to clinical evidence of CHD: 237 patients with angina pectoris and/or myocardial infarction (CHD+ group); 720 patients without evidence of CHD (CHD- group). Coronary angiography was performed on 200 patients from this sample population; these patients were also divided into two groups: 119 patients with greater than 50% luminal narrowing of at least one major coronary artery (stenosis+ group); 81 patients with no significant atherosclerotic changes in the coronary arteries (stenosis- group). EC was present in 58 of 237 CHD+ patients (24.5%) but in only 35 of 720 CHD- patients (4.8%; P less than 0.001); it was present in 31 of 199 stenosis+ patients (26.1%) but in only 3 of 81 stenosis- patients (3.7%; P less than 0.01). EC was also found to correlate significantly with some coronary risk factors; the correlations between the presence of EC and the presence of CHD and coronary risk factors were investigated by multivariate analysis. In a multivariate setting, the existence of CHD and an age of over 50 years was significantly related to the presence of EC. To investigate the relationship between EC and advancing age, all patients were separated into age-groups.(ABSTRACT TRUNCATED AT 250 WORDS)

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The levels of proelafin peptides in the sera of patients with pustulosis palmoplantaris, a unique type of localized pustular psoriasis, and generalized pustular psoriasis were determined by competitive enzyme-linked immunosorbent assays using antibodies against synthetic proelafin polypeptides corresponding to the elastase inhibitor (elafin) and transglutaminase substrate domains. The sera of patients with pustulosis palmoplantaris (9 cases) exhibited a normal range of proelafin peptide levels. The sera of patients with generalized pustular psoriasis (3 cases) showed high titres of proelafin peptide. There were no large differences in the titres between the 2 antibodies. The antibodies for 2 different domains of proelafin showed a similar immunoreactivity for the non-pustular region of the epidermis in all pustulosis palmoplantaris tested. The results indicate that serum proelafin peptides in pustular psoriasis may depend on the extent of the involved area, and that proelafin peptide level in pustulosis palmoplantaris remains normal despite enhanced local expression in the lesional skin. Since the skin lesions of patients with pustulosis palmoplantaris are limited to the palms and soles, enhanced expression of proelafin in the lesional skin may not lead to elevation of proelafin peptides in the serum.

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