Deciphering the CLOVES Acronym

C is for Congenital, which means something you are born with. All people diagnosed with CLOVES had some symptoms at birth or in utero.

L is for Lipomatous, which means fatty or having to do with fat. Typically most CLOVES patients have a soft fatty mass at birth, often visible on one or both sides of the back and abdomen.

O is for Overgrowth, which means people with CLOVES may grow some areas of their bodies, at a much faster rate than others. 

V is for Vascular Malformations.  These can range from mild to complex. People with CLOVES have ‘different’ venous, capillary and lymphatic channels (the systems that are responsible for blood flow and the lymph system). Typically capillary, venous, and lymphatic malformations are known as “slow flow” lesions. Capillary malformations are reddish/pinkish birthmarks. Prominent veins are also common. Some people with CLOVES have fast-flow vascular malformations (known as Arterio-Venous Malformations – AVM) which are rare and aggressive. Some people with CLOVES have overgrowth over/nearby their vascular malformations. The effect of a vascular malformation on a person has much to do with the kind, size, location, etc. of the malformation, and symptoms can vary greatly.

E is for Epidermal Nevus, which is a skin lesion that can be flat, tan, or slightly raised.

S is for Spinal/Skeletal Anomalies or Scoliosis. Some people with CLOVES have tethered spinal cord, vascular malformations in/around their spines and other spinal differences. High flow, aggressive spinal lesions (like AVM) can cause serious neurological deficits/paralysis.

There are a variety of signs and symptoms not covered in the CLOVES acronym. These include: overgrowth of extremities (usually located on the arms or legs), large wide hands or feet, large fingers or toes, wide space between the toes and fingers and asymmetry of body parts. Other skin abnormalities include lymphatic vesicles (look like blisters) and other birthmarks. Some people with CLOVES have different orthopedic challenges (define) related to knees or hips. Some people with CLOVES have different sizes or absence of a kidney.

CLOVES is caused by a somatic genetic mutation in a gene called PIK3CA that increases the activity of the gene. CLOVES belongs to a category of diseases known as PIK3CA-related overgrowth spectrum or PROS.