TNF and peeling skin syndrome: However, glandular tissue in pSS is heavily infiltrated by T lymphocytes in the multiple phases of the disease (4), and B-cell depletion with rituximab also failed to improve pSS symptoms (36), suggesting that T cells also play an indispensable role in the pathogenesis of pSS.Th1 and Th2-derived cytokines such as IL-1, IL-6, IL-4, IL-10 TNF-α, and IFN-γ mediate the pathological damages in the exocrine gland (37, 38).