Clinical manifestation

Glandular symptoms: dry eye syndrome, characterized by dryness of cornea and conjunctiva; dry mouth; dry lips; red, smooth dry tongue; dental caries; recurrent oral candidiasis; recurrent salivary gland swelling; nasal dryness with recurrent infections, hoarseness, and aphonia; atrophic changes in the vulva and vagina, resulting in pruritus and vaginitis; anal and rectal mucosal dryness Skin symptoms: xerosis; decreased sweating; dry, sparse hair; annular, red, scaly plaques, especially on face and neck; cutaneous vasculitis

Primary variant: no associated connective tissue or autoimmune disease; extraglandu-lar involvement: lung involvement, nervous system dysfunction, renal involvement, Raynaud phenomenon, and lymphoprolif-erative disorders

Secondary variant: associated connective tissue or autoimmune disease; milder disease with fewer systemic manifestations

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