The disease usually begins with a palm nodule (can resemble a callus) that develops at the base of the ring or little finger. Gradually a prominent cord develops as the palmar fascia thickens. As the process continues the overlying skin puckers, dimples, and roughens. The thick cords contract slowly over time, drawing the fingers into the palm and may draw adjacent fingers together. The ring and little finger are most commonly affected and usually are affected first. Progression is often erratic and arbitrary with no obvious cause.
Associated conditions include the formation of pads on the top of the knuckles called “knuckle pads”, fibrous plaques on the penis called “Peyronie’s Disease”, and a disease syndrome on the bottom of the feet, similar to what takes place in the palm, called “Ledderhose’s disease”.