In patients with pSS, there is an elevated proportion of CD4+CXCR5+Tfh cells in both salivary glands and peripheral blood (19, 39), Preliminary studies have indicated the importance of the IFN-α-JAK–STAT1 signaling pathway and the TOX-Bcl6 axis in Tfh cell activation (40). This evidence concerns the gene IFNA1 and peeling skin syndrome.