Paired Ear Creases of the Helix: A Possible Physical Sign

In 2017, a case study reported the first instance of paired ear creases of the helix (PECH) in a 68-year-old South Asian man with coronary artery disease and a diagonal ear lobe crease. The researchers suggested that these ear creases, similar to diagonal ear lobe creases (often known as Frank's sign), might be associated with cardiovascular disease. The formation of these creases was postulated to be due to pressure during sleep on a hard surface. However, the pathophysiological association of these creases to coronary artery disease and metabolic syndrome was not well understood. The researchers proposed that PECH could potentially serve as a new physical sign of susceptibility to these conditions, warranting further investigation.