J Cutan Pathol 2012: 39: 78–79doi: 10.1111/j.1600-0560.2011.01750.xJohn Wiley & Sons. Printed in Singapore

Copyright © 2011 John Wiley & Sons A/S

Journal ofCutaneous Pathology

Letter to the Editor

Methodology matters, but. . .

Keywords: stem cell marker, nestin, scarring alopecia

To the Editor,In the extensively researched manuscript by

Sellheyer, the author emphasizes the need for cautionin the interpretation of immunohistochemicalmarkers with particular emphasis on the stainingof putative stem cell markers.1 The author includedselected figures (Figures 2D and 2E from Ref 1)from our previously published paper2 and statesthat the arrowhead supposedly highlights ‘staining ofnestin in the mesenchyme surrounding the epithelialcomponent of the hair follicle whereas the hair follicleepithelium is negative’. The author’s new figurelegend concerning our published figures is incorrect.To corroborate this, we include the same imagesat high magnification (Fig. 1), which demonstrate

Fig. 1. Scarring alopecia: (A and B) vertical and (C and D) horizontal tissue sections demonstrating nestin staining in the infundibular region(A/C = 20×, B/D = 40×).

nestin cytoplasmic staining surrounding negativekeratinocyte nuclei of follicular epithelium, whilethe perifollicular fibrosis/mesenchyme is negative.The author further emphasizes that ‘stringentantibody incubation conditions are necessary fornestin expression and that. . . an artificial backgroundstaining for nestin can be observed in theepidermis’. In the very same paper,2 we have clearlydemonstrated that our positive internal control wasnestin staining within endothelial cells and thatthere was no non-specific staining in the epidermis.This was also apparent in other figures in ourpublication.2

Methodology matters but. . . a picture is worth athousand words!

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Letter to the Editor

Mai Hoang, MD1

Meera Mahalingam, MD, FRCPath2

1Department of Pathology, MassachusettsGeneral Hospital and Harvard Medical School,

Boston, MA, USA and

2Dermatopathology Section, Department ofDermatology, Boston University School

of Medicine, Boston, MA, USAe-mail: mmahalin@bu.edu

References1. Sellheyer K. Stem cell markers can help identify

adnexal tumor differentiation when evaluatedin the context of morphology: methodologymatters. J Cut Pathol 2011; 38: 560–574.

2. Hoang MP, Keady M, Mahalingam M. Stemcell markers (cytokeratin 15, CD34 and nestin)in primary scarring and non-scarring alopecia.Br J Dermatol 2009; 160: 609.

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