It has been my experience with this disease that fatigue plays a part as well as joint pain, muscle pain and body aches. Malaise and the feeling of being unwell also is a condition and a part of PN that I live with.
Regards Chuck

I think it started in the gut. That’s where my hoshimotos stsrted.
And I’m with you about staying calm and cool. I keep my bedroom at 65 and ice packs ready in the freezer in case I wake myself up itching. The cold helps relieve the pain and itch

It is hard to understand what they believe. It truly seems that it is completely misunderstood. I read at “very well health,” “Prurigo nodularis (PN) is a chronic inflammatory skin disease that causes itching and bumps across the arms, legs, and chest. Many times, there is an underlying disease that leads to itching. The underlying disease is sometimes cancer—the most common being blood cancers and skin cancers.“. I truly do not know exactly how one would know.

I have multiple auto-immune diseases, and though the diagnosis of Prurigo Nodularis is new to me, I know now I have had it for 20+ years. PN seems very neurological to me. The systemic symptoms seem to affect me the same as M.S., or R.A. I notice that when Raynaud’s surfaces, so does PN. Funny, they do not know what causes any of these and there is no cure but they all affect my nervous system and are very triggered by heat and cold. Stress is our worst enemy. If I stay cool and calm I can cope way better with the symptoms.

As for your question, I am not sure if they truly know if there are underlying conditions. It is hard to study a rare disease. I don’t think PN would be on the radar right now if Dupixent hadn’t been able to piggy back it to their eczema/asthma treatment. There certainly aren’t enough people with PN to interest a drug company.

I agree that there is something else going on with PN -- I share many of your symptoms and the pain in my leg (the same one with a hip replacement) hurts a lot.