Studies show that pSS patients with late disease onset have lower levels of autoantibodies such as RF, ANA, anti-Ro/SSA, or anti-La/SSB antibodies in comparison to younger pSS patients.[8,10,28,32] Our results demonstrated that the level of inflammatory biomarkers (ESR) was higher, and the level of C4 was lower in the EopSS patients. The gene discussed is C4A; the disease is peeling skin syndrome.