PD-1hiCXCR5− CD4+ T cells described as peripheral helper T-cells (Tph) lie in the “Tfh-like cells” population, and increased numbers of Tph cells in peripheral blood of pSS patients compared to healthy controls have been observed, but in lower frequency compared to circulating Tfh-cells [25,90], denoting a probable minor implication. Here, CD4 is linked to peeling skin syndrome.