| Course | PA 510 Comprehensive Clinical Module Dermatology |
|---|---|
| Week | 4 |
| Paper type | Clinical photograph critique |
| Length | About 850 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 510 Week 4
Clinical Photograph Critique: A Phone Picture of the Shin Taken Under a Kitchen Light With the Flash On, Audited Before It Is Read
Student Name
Chamberlain University
PA 510: Comprehensive Clinical Module Dermatology
Instructor Name
Month Day, Year
Clinical Photograph Critique: A Phone Picture of the Shin Taken Under a Kitchen Light With the Flash On, Audited Before It Is Read
The Exhibit, Described
The image under review is a single photograph D.O. uploaded to the clinic's messaging system on the Friday before the first visit, with the message "this is the worst one." It shows the front of the left shin. The file is a phone camera image, 3024 by 4032 pixels, taken at night in a kitchen under a ceiling light, with the phone's flash on.
Distance: close, about 20 centimeters from the skin, so the frame covers roughly 15 by 20 centimeters of shin. The knee and ankle are both out of frame, so the location on the leg can be inferred only from the patient's message.
Size reference: none. There is no ruler, coin or other object of known size in the frame.
Lighting: the flash is the main light. It has produced a bright white reflection across the upper third of the plaque and flattened the surface texture, and the warm ceiling light has added a yellow cast to the surrounding skin.
Focus: the center of the image is sharp; the left edge, where the plaque ends, is soft.
Surrounding skin: about 3 centimeters of normal skin is visible on the right side, none on the left.
Second view: none. No distant view of both legs and no side-lit view.
Technical guidance for skin images recommends an overview image to place the lesion, a close-up with a scale, diffuse lighting without flash glare and a neutral background (Finnane et al., 2017). This image meets none of those.
What Can Be Read
Within those limits, the picture shows a raised plaque with a gray-white surface layer covering most of its visible area. Darker violet-brown papules are visible at the right edge, where normal skin is in frame. On the lower third, two short straight dark red lines with a darker crust are visible.
Nothing to Measure Against
Without a scale, size cannot be read from the image. The patient's message describes the plaque as "about the size of my palm." That is recorded as the patient's estimate. At the visit, the plaque measured 6 by 4 centimeters with a ruler; the photograph could not have produced that figure.
Color Under a Flash
The flash makes the scale look brighter and whiter than it was in the clinic and washes out the violet tone of the papules, which in the image look brown. A reader relying on this photograph would describe the color of the eruption differently from the clinic description, and on darker skin, where violet tones are already subtle, that loss is larger. The color of the lesions should not be taken from this image.
Two Ways of Being Open
Two kinds of uncertainty must be kept apart. The first is uncertainty produced by the file: size, true color and the far edge of the plaque cannot be read because of how the picture was taken. The second is uncertainty that would remain with a perfect image: whether the plaque is lichen planus or a lichenoid drug reaction cannot be settled from any photograph. Calling the image "inconclusive" without separating these would make it impossible to know whether a better photograph would help.
What Each Absence Would Settle
A ruler in frame would have given size. Diffuse daylight without flash would have given color and surface texture. An overview of both legs would have shown symmetry and the upper and lower limits. A side-lit close-up would have shown whether the flat tops carried a fine white network. None of these would have settled the diagnosis, but together they would have made the image a usable record for comparison at the next visit.
Who Took It, and Why That Matters
The patient took the picture alone, holding the phone in one hand while sitting on a kitchen chair with the leg raised, which explains the close framing and the cut-off knee and ankle. That context is recorded because it tells the next reader that the framing reflects the circumstances, not a choice to show only the worst part. It also suggests a fix: a second person, or a phone propped on a shelf with a timer, would allow an overview image. When patients are asked to send photographs before a visit, a short instruction sheet asking for daylight, no flash, a coin or ruler and one distant view would prevent most of the problems found here.
Verdict
The image is readable for the presence of a scaly raised plaque with scratch marks on the left shin and for nothing more precise. It is not usable for size, color or extent. For the record, the clinic took a replacement set at the visit following the same guidance, which is the set later used for the referral.
References
Finnane, A., Curiel-Lewandrowski, C., Wimberley, G., Caffery, L., Katragadda, C., Halpern, A., Marghoob, A. A., Malvehy, J., Kittler, H., Hofmann-Wellenhof, R., Abraham, I., & Soyer, H. P. (2017). Proposed technical guidelines for the acquisition of clinical images of skin-related conditions. JAMA Dermatology, 153(5), 453-457. https://doi.org/10.1001/jamadermatol.2016.6214
What the PA 510 Week 4 assignment asks for
The fourth week asks you to critique a clinical photograph in two parts that must connect. First, audit the exhibit: distance from the skin, whether any size reference is in frame, the lighting and what it has done to color, focus, how much surrounding skin is included and whether other views exist. Compare the image with accepted technical guidance for skin photography, with a source. Second, describe what the image shows in the terms the course has used, staying inside what the audit allows. Separate two kinds of uncertainty: what cannot be read because of how the image was taken, and what would remain open even with a perfect image. Say what each missing element would have settled. Finish with a verdict on what the image can and cannot be used for.
How this PA 510 Week 4 example is built
The exhibit is a single phone photograph sent before the first visit, taken at night under a ceiling light with the flash on, about 20 centimeters from the left shin, with the knee and ankle out of frame. The audit records no size reference, a bright flash reflection over the upper plaque, a yellow cast from the ceiling light, a soft left edge, normal skin on one side only and no second view, and compares each point with published imaging guidance. The reading then describes only a raised plaque with gray-white scale, darker papules at one edge and two short scratch lines. Size is left to the ruler measurement from the visit. The flash is shown to have washed out the violet tone, which matters more on dark skin. Two kinds of uncertainty are separated, a section explains how the patient took the image alone, and a verdict closes the critique.
Where the points sit in the PA 510 Week 4 rubric
Most points are lost when the two halves never meet: a careful audit of the image followed by a confident reading as though the audit had not happened. Collapsing two verdicts comes next, where inconclusive covers both a file nobody could read and a readable file showing a genuinely open question. Color called from a flash image without a sentence about the flash costs a row on its own. Further deductions follow for size estimated with no reference in frame, for missing views not named, for audit points made without any accepted guidance behind them and for a critique that stops at unusable without saying what the image can still show. Strong critiques audit first, read within the audit's limits, separate file-caused from case-caused uncertainty, state what each missing element would have settled and end with a clear verdict on the image's uses.
PA 510 Week 4 help from the desk
Photograph critiques ask you to think like a photographer and a clinician at once, and most drafts lean too far toward one. If you share the image your section assigned, we can help you audit distance, scale, light, focus and framing against published imaging guidance, then write a reading that stays inside those limits. We can also help you separate what the file makes unreadable from what would stay uncertain with any image, which is the distinction markers look for. Explaining how lighting affects color, especially on darker skin, is another part we can help you state clearly. The verdict is yours to reach. If your rubric names its own checklist for clinical images, the custom sample audits against that checklist item by item.
Get a PA-510 Week 4 example written to your instructions
Send the image set your classroom posted, the instructions and the rubric, and a custom critique written against those exact files returns inside 24-48h, the first one free. Photographs of a real person stay with whoever took them and with the consent attached to them, so the desk works from your classroom's own material rather than sourcing pictures.
More PA 510 papers and MPAS samples
- PA 510 Week 1: Scale Versus Crust Post
- PA 510 Week 2: Lesion Morphology Description
- PA 510 Week 3: Distribution Pattern Analysis
- PA 510 Week 5: Skin Tone Description Audit
- PA 510 Week 6: Pigmented Lesion Evaluation
- PA 510 Week 7: Biopsy Site Justification
- PA 510 Week 8: Teledermatology Referral Brief
- PA 505 Week 4: Criteria Application Exercise
- PA 504 Week 4: Review of Systems Draft
- PA 503 Week 4: Diagnostic Schema
- PA 502 Week 4: Surrogate Outcome Critique
PA 510 Week 4 questions, answered
Are we critiquing the photograph or the finding?
Both, in that order, and most rubrics carry a row for each. The image is assessed as evidence first: what it captured and how well. Only then does the description run, and it stays inside what the file supports. Sections marking this closely deduct wherever a confident reading follows an audit that had just found the image poor.
Can the critique conclude the image is unusable and stop there?
It can reach that conclusion, but stopping there gives up the rest of the rubric. The finished version states what would make the image usable, which view or which distance, and then describes whatever the current file does support, however little that turns out to be. A one-line rejection answers the smallest part of the assignment.
Do we need photography terminology?
A little, and plain wording is accepted almost everywhere. Focus, distance, lighting and framing are the four that recur, and using them consistently matters more than reaching for technical names. What gets marked is whether each observation about the file is tied to a consequence for the description that follows it.
Where can I find a free PA 510 Week 4 sample paper?
You can read the complete PA 510 Week 4 critique of a flash-lit phone photo of a shin plaque, audited before it is read, on this page.
What two kinds of uncertainty does the PA 510 Week 4 sample separate?
What cannot be read because of how the image was taken, such as size and color, and what no photograph could settle, such as the diagnosis.