many cutaneous manifestations of systemic disease and the use of potentially toxic systemic therapies were felt to be the most important reasons for possessing this qualification.In 1993, following the General Medical Council's recommendations, 2 new undergraduate curricula were introduced in all U.K. medical schools. However, undergraduate exposure to dermatology at the time remained highly variable 1 and our findings suggest that this still appears to be the case. Over the past decade significant work has been undertaken by the British Association of University Teachers of Dermatology (BAUTOD) to address and improve the teaching of dermatology within medical curricula. 3 However, the fact that such a high proportion of those surveyed wished for more exposure at both undergraduate and postgraduate levels continues to place a degree of responsibility on all dermatologists to respond to such requirements.Despite the drastic changes to postgraduate medical education that have taken place in recent times, dermatology has maintained its position as a core component of the curriculum of general internal medicine. Whether the graduate practises in hospital medicine or primary care, we would argue that the teaching of dermatology remains important as previous studies have noted that at postgraduate level little attention is given to the skin even when relevant to the general medical condition of hospital inpatients 4 and up to 15% of GP consultations are specifically related to the skin. 5 The lack of confidence displayed by junior doctors in their ability to describe a rash is somewhat alarming given the possibility of our cohort encountering a dermatological case in their PACES examination and beyond this, in real life medical practice. The recent transition to competency-based graduate training may address this, as well as issues relating to the performance of routine bedside dermatological investigations.Although U.K. graduates comprised one-third of those surveyed, we feel the findings remain very relevant to U.K. dermatology teaching and practice. Overseas doctors made up 33% of U.K. senior house officer posts and 14% of preregistration house officer posts in 2003 6 and continue to give invaluable service commitment to the NHS while working in training grades. Indeed, in many district general hospitals more than two-thirds of junior doctors have trained overseas. 6 In conclusion, the findings from our survey highlight the importance of retaining dermatology teaching as a core component of the undergraduate medical curriculum. In addition the findings would seem to strengthen the case for ensuring that dermatology posts are part of the 2-year foundation programme as well as part of core medical training. Only through increased exposure to the specialty at both undergraduate and postgraduate level can we hope to see an improvement in junior doctors' basic dermatology skills. Furthermore, we believe that an increased understanding of the specialty (ultimately through increased exposure) remains the most effective...

OBJECTIVES: The article reports the case of encephalocele nasofrontal in an infant, relating to the genetic, syndromic and socioenvironmental factors, showing the importance of the health team being attentive to the findings, being a malformation, with a high mortality and morbidity rate and having few reports in the literature. CASE REPORT: Infant, female, born at term, vaginal delivery, 3.570g, natural and coming from Uberaba. After birth, she was hospitalized for a congenital heart disease and Down syndrome, cardiac surgery was performed. In this period, the respiratory physiotherapist perceived the difficulty of introducing the nasal aspirate, and was sent to the otorhinol, without statistical findings, a cranial tomography was performed at 4 months, which diagnosed an infant with nasoethmoidal and nasofrontal encephalocele. The encephalocele is a rare anomaly, with high morbidity, mortality and risk of complications. It is related to other pathologies diagnosed in patients and to the antecedent factors at birth, genetic and environmental causes. COMMENTS: Although it is difficult, with high mortality and morbidity, it is of great value to know about the factors that are related to this anomaly, both for the early diagnosis and for the prevention.