CALR and peeling skin syndrome: The criteria only apply to patients with at least one clinical manifestation of pSS, such as oral or ocular dryness, and include keratoconjunctivitis sicca with ocular staining, salivary gland biopsy with lymphocytic sialenditis (focus score of > 1 focus/mm2), antibodies positive for anti-SSA (Ro) and/or anti-SSB (La), positive test result for rheumatoid factor (RF) or anti-nuclear antibody (ANA), Schimer’s test indicative of decreased tear production, and decreased unstimulated salivary flow [2].