A recent study of human minor salivary glands in female pSS patients also found multiple annexins with differential transcription regulation (A6 upregulated, A2, A3, A4, A5, A7 downregulated and the A2 receptor upregulated), deregulated HSPs, along with upregulated proteinases like MMP9 and various serpins (58). Here, MMP9 is linked to peeling skin syndrome.