Pathophysiology
At first there may not be any obvious link between coronary arteries and ear lobes however a few papers shed some light on this issue. Autopsy studies involving biopsies of ear lobes in patients with DELC found thickening of arterial walls and tears in the elastin(21) and that both earlobe and myocardium are supplied by end arteries without collateral circulation(22). More recently Stoyanov(23) found that patients with DELC had diffuse fibrosis of an arterial vessel located at the base of the ear lobe crease and that this was associated with corresponding changes to myocardial tissue. As with our study, Stoyanov et al also found that this correlation was independent of age. As has been suggested in an earlier study(21), a reduced blood supply to the ear lobe could cause destruction of the elastin which manifests as creases in the ear lobe. It is feasible therefore that the same atherosclerotic processes that causes narrowing of coronary arteries may be causing a similar effect in the blood vessels supplying the ear lobe.