The skin develops tiny fluid filled blisters. They usually fill with a small amount of pus, then turn brown, then scaly. The scaling may be so prominent that only redness and scaling is seen. The pustules are sterile pustules; there are no germs in them and they are not contagious. They come in waves or crops on one or both hands and/or feet. They are associated with thickened, scaly, red skin that easily develops painful cracks (fissures). It is not caused by any known allergy or food.

The condition varies in severity and may persist for many years. It is not known what triggers flare-ups. It has little effect on the health in general, but can be very uncomfortable. Usually, pressure, rubbing and friction will worsen PPP.

Treatment does not cure the disorder, but the symptoms can usually be controlled. No treatment works for everyone. Some trial and error may be needed to find a successful treatment.

Superpotent topical steroid ointments (Temovate, Ultravate, and Diprolene) applied overnight covered with Saran Wrap for a few days are often very helpful. Prolonged occlusion, in which a milder steroid is left, covered with a plastic bandage for 7 to 10 days, can be even more helpful. However these very potent products should be used only for limited period's or else skin damage and loss of effectiveness will become a problem. Once improved, an application of a moderately strong topical steroid can be applied twice daily to the affected area to maintain improvement

Soaks in tar solution (Zetar emulsion or Balnetar) or Crude coal tar and salicylic acid ointment (very messy) applied directly to the pustules every few days or so can stop them occurring or help peel off scale (see treatments).

Tazorac gel or Dovonex ointments are very helpful to some patients alone, and increase effectiveness when added to other treatments. They can be irritating and are very expensive, but they don't damage the skin as steroid ointments can.

Ultraviolet light, with or without an oral medication called Oxsoralens (PUVA), is very effective for those who do not improve with creams and ointments. It is usually given in the Doctors office three times per week. Burns, sometimes enough to blister the skin, occasionally occur. A milder, home treatment is available.