TNF and peeling skin syndrome: From a biological standpoint, patients with pSS and pulmonary involvement presented higher TNF-α levels (p < 0.001), higher IL-6 (p < 0.001) and IL-8 levels (p < 0.001), as well as higher serum leukocyte (p < 0.001) and lymphocyte levels (p < 0.01), values that were significantly higher than in their pSS counterparts who did not present pulmonary involvement.