C4A and peeling skin syndrome: Laboratory testing may reveal high erythrocyte sedimentation rate (ESR), positive antinuclear antibody (ANA) in up to 83% of patients with pSS (6), anti-Ro/SSA and/or anti-La/SSB antibodies, respectively, detected in 40–75 and 23–52% of pSS patients (7), and low C4 levels (4).