Abstract
The utility of labial salivary gland (LSG) biopsy, with the recognition of focal lymphocitic sialadenitis (FLS) and the assessment of Focus Score (FS), for the diagnosis of Sjogren's syndrome (SS) is well-known. This Letter to the Editor following an article recently published by Sebastian et al. highlights that LSG biopsy is not always crucial for characterization of patients with secondary SS. Some criticalies are still present, especially in older patients. Furthermore, immunoistochemical studies did not found relevant differences in systemic autoimmune rheumatic diseases associated with SS, with the exception of rheumatoid arthritis (RA) with sicca- related manifestations,
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