Questions and Answers

Journal of the American Academy of Dermatology

Correspondence

862

modalities in combination, particularly tretinoin (RetinA) and collagen injection in the same patient. Although adverse reactions to Zyderm and Zyplast are rare and irritation from tretinoin is common, when the patient has undergone soft tissue augmentation and is using trefinoin cocnomitantly, there may be confusion on the part of both patient and physician when an erythematous reaction occurs. There are ways to distinguish the irritant nature of tretinoin A from the adverse reaction to collagen, which probably should be reviewed. Adverse reactions to collagen-injectable material should be limited to the area of augmentation; they appear as a series of "mosquito bites" and will not be

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affected by topical steroids nor by discontinuation of the tretinoin. The irritant reaction resulting from tretinoin appears more like a burn, extends beyond anatomic units, is benefited by topical steroids, and subsides with discontinuation of the tretinoin. These points may be of benefit to those who are performing soft tissue augmentation with the use of collagen-injectable materials and at the same time have patients using tretinoin.

Melvin L. Elson, MD 4535 Harding Rd. Nashville, TN 37205

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QUESTIONS AND ANSWERS God You made us perfectly Imperfect-Mortal, So that life Survives-Unique and diverse, So as to furnish Continuity, Able to impart Values To the valueless And meaning To the meaningless-Making philosophized sense Of your immense Experiment. It is hard, God, When we are divided, In our philosophies, When we have Wars About Religion, Murders Over the color Of our Skins,

Conflicts about Abortion-About what Life is.

Yes, Life is A conceptus Before It thinks Before It feels Before It has eyelashes or Eyebrows, When it is all Pink Smooth New and Virginal-Before the Details-But Life is Also A sperm, An egg, A single c e l l . . .

Are we murderers then When we spill Our seed? When we shed An egg?

Is it really Wrong To murder? Does Life Matter? In this Age of Science We know That it does not And yet We are correct To value i t . . . These Questions Are too hard To ask And we are too Uncomfortable To ask them Often

Or Of you We are afraid Of the questions Because We are afraid Of the answers. We have great need To let Our manufactured answers Rest But We find We have become So tenacious Of l i f e . . . Of t h o u g h t . . . That we cannot escape The questions And so We must ask them Of you, God. God. God?

--Joseph M. Scherzer, AID Scottsdale, Arizona