The serum levels of alpha-1B-glycoprotein, alpha-1-microglobulin, CD5 antigen-like OS, clusterin, hemopexin, type I cytoskeletal 9, and putative macrophage-stimulating 1-like protein were lower in pSS patients with NMOSD than without NMOSD, while CFH and HP protein OS were higher in pSS patients with NMOSD. This evidence concerns the gene KRT9 and peeling skin syndrome.