Relationship between diagonal earlobe crease (Frank's sign) and international index of erectile dysfunction score (IIEF-5)

Abstract

The objective of this study is to examine the association between erectile dysfunction (ED) and the presence of diagonal earlobe crease (DELC), a physical sign commonly associated with atherosclerosis. A total of 96 male patients, aged between 50 and 65 years, were referred to our institute between December 2020 and March 2021 for various urological conditions. These patients were included in the study. Erectile performance was assessed using the IIEF-5 score, and DELC was visually identified by a urologist. The patients were administered the IIEF-5 questionnaire, and the results were categorized into two groups: the DELC group included patients with an earlobe crease, while non-DELC group consisted of patients with normal earlobes. In total, 96 patients participated in the study. We observed a decrease in IIEF-5 scores among patients in the DELC group compared to those in the non-DELC group. A statistically significant difference was found between the DELC group and the non-DELC group (p < 0.01). This study demonstrates that the presence of an earlobe crease may serve as a predictive sign of atherogenic erectile dysfunction in male patients aged 50–65 years. Further investigations should be conducted to explore the utility of DELC as a standard indicator during the physical examination of erectile dysfunction.