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The diagnosis of polycystic ovary syndrome (PCOS) remains uniquely dependent on physical examination signs. Diagonal earlobe crease (DELC) also referred to as “Frank’s sign, has been associated with several cardiometabolic disorders with further investigations reporting that its occurrence was more prevalent among aging men and thought to a sign of aging skin. However, there is no clear mechanism of development or rationale behind such associations. The author is reporting a novel association between Frank's sign and PCOS in a 23-year-old female patient. The presence of the DELC in young women could alert clinicians to the need to further investigate a diagnosis of PCOS. The author is providing an accompanying hypothesis to suggest possible common pathogenesis that links the two to visceral adiposity of the face.

Frank’s Sign in Polycystic Ovary Syndrome and Sideburn Adiposity: A Case Report and Illustrated Hypothesis