| Course | PA 510 Comprehensive Clinical Module Dermatology |
|---|---|
| Week | 5 |
| Paper type | Skin tone description audit |
| Length | About 850 words, 4 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 5
Skin Tone Description Audit: An Urgent Care Note That Called the Wrist Rash "Mildly Erythematous" and the Shins "No Erythema," Rewritten Term by Term
Student Name
Chamberlain University
PA 510: Comprehensive Clinical Module Dermatology
Instructor Name
Month Day, Year
Skin Tone Description Audit: An Urgent Care Note That Called the Wrist Rash "Mildly Erythematous" and the Shins "No Erythema," Rewritten Term by Term
The Note Being Audited
Five weeks before the first clinic visit, an urgent care clinician examined D.O. for an "itchy rash." The skin section of that note is reproduced here with permission for teaching, as written:
"Skin: mildly erythematous papules on bilateral wrists. Shins with dry flaky patches, no erythema, likely xerosis. Some hyperpigmented areas on legs, probably post-inflammatory, not concerning. Skin otherwise normal color. No lesions of concern."
The note was written about a patient with dark brown skin. The plan was a moisturizer and an over-the-counter hydrocortisone cream.
Why the Audit Matters
Medical teaching images have shown light skin far more often than dark: in one analysis of over 4,000 images in widely used medical textbooks, 4.5% showed dark skin tones (Louie & Wilkes, 2018). Descriptive terms learned from those images often assume redness can be seen. On darker skin, inflammation may look violet, gray, dark brown or not distinctly colored at all, and a note built on redness can miss it.
The Term-by-Term Audit
Table 1
Terms in the Urgent Care Note, the Assumptions Behind Them and Their Replacements
| Original term | What it assumes | What goes in its place |
|---|---|---|
| Mildly erythematous papules | That inflammation shows as redness and its degree can be read from the shade of red | Flat-topped, polygonal papules, violet-gray, darker than surrounding skin, 2 to 5 millimeters, firm |
| Dry flaky patches | That the surface change is dryness, and that patches are flat | Raised plaques with thick gray-white adherent scale, largest 6 by 4 centimeters, felt as raised above the skin |
| No erythema | That absent redness means absent inflammation | Plaque borders warmer than adjacent skin to the back of the hand; violet-brown papules at the edges; itch reported as severe |
| Likely xerosis | A diagnosis drawn from the assumption above | Removed; description only |
| Hyperpigmented areas, probably post-inflammatory | That dark areas are the aftermath of something finished | Violet-brown papules and plaques that are raised and firm, active, not flat marks |
| Not concerning | A judgment without the features that support it | Removed |
| Skin otherwise normal color | That a single normal color exists to compare against | Unaffected skin uniformly dark brown; regions examined are listed |
| No lesions of concern | A conclusion with no listed examination | Removed; regions examined and not examined listed |
Note. Note. Replacements are observable properties recorded at the clinic visit.
Replacements You Can Observe
Every replacement in the right column is something a second examiner could check: whether the lesion is raised under a fingertip, its size, its border, whether it is warmer than adjacent skin, whether scale lifts or adheres, and a narrower color word such as violet-gray in place of red. None of the replacements is a warning that color may look different on dark skin. A warning would leave the description exactly where it started; a property replaces the assumption with a finding.
Site by Site
The same substitution does not work everywhere. On the wrists, the papules were distinctly darker and violet, so a color word was useful once narrowed. On the shins, color was less informative than texture and thickness, so the replacement relies on scale and elevation. In the mouth, where the network inside the cheeks was white against pink mucosa, color terms work as they would for anyone.
The Terms That Survived
"Papules" on the wrists survives; the urgent care note was right that the lesions were small and raised. "Bilateral" survives. The audit lists these so that a reader can see every term was examined, not only the faulty ones. The glossary terms used in the replacements follow the international lesion glossary (Nast et al., 2016).
Checking the Audit Against the Patient
An audit of words can drift away from the person they describe, so each replacement was checked at the clinic visit against D.O.'s skin rather than against a textbook. Warmth was compared with the back of the examiner's hand on the plaque and on skin 5 centimeters away. Elevation was confirmed with a fingertip and with light from the side. Scale was tested with a gloved fingernail to see whether it lifted or held. Where a replacement could not be confirmed, the row would have said so; none needed that note. The patient was asked how the rash looked to them, and said, "darker, and shiny, like it's under the skin." That description, in the patient's own words, matches the replacements more closely than the original note did.
What the Audit Changed
The original note led to a moisturizer for what it called dryness. The rewritten description, with raised violet-gray polygonal papules and thick scale, leads a reader to an inflammatory eruption needing a different evaluation, which is what happened at the clinic visit five weeks later.
References
Louie, P., & Wilkes, R. (2018). Representations of race and skin tone in medical textbook imagery. Social Science & Medicine, 202, 38-42. https://doi.org/10.1016/j.socscimed.2018.02.023
Nast, A., Griffiths, C. E. M., Hay, R., Sterry, W., & Bolognia, J. L. (2016). The 2016 International League of Dermatological Societies' revised glossary for the description of cutaneous lesions. British Journal of Dermatology, 174(6), 1351-1358. https://doi.org/10.1111/bjd.14419
Reading the PA 510 Week 5 instructions
Week five asks you to audit a written skin description, usually someone else's, for terms that assume a particular skin tone. Reproduce the original wording. For each term, state the assumption it rests on, such as that inflammation always shows as redness, and give a replacement. Replacements should be observable properties, such as elevation, warmth, scale, border or a narrower color word, rather than warnings that color may look different. Work site by site, since a substitution that works on one area may not work on another. Report the terms that survived as well as those you changed, so a reader can see everything was examined. Support the reason for the audit with evidence. Close by saying what the rewritten description changes for the patient's care.
Inside the PA 510 Week 5 example
The audit reproduces an urgent care note written five weeks before the clinic visit: mildly erythematous papules on both wrists, dry flaky patches on the shins with no erythema and likely xerosis, hyperpigmented areas called post-inflammatory and not concerning, and skin otherwise normal in color. It cites a study of over 4,000 textbook images in which 4.5% showed dark skin. A table then gives eight rows, each with the original term, its assumption and a replacement such as flat-topped polygonal violet-gray papules, raised plaques with thick adherent scale, warmth at plaque borders or a list of regions examined. A section explains why each replacement is a property and not a warning. Site differences are shown for the wrists, shins and mouth. Surviving terms are listed, the replacements are checked against the patient's skin, and the close shows how the rewrite moves care from moisturizer toward evaluation of an inflammatory eruption.
PA 510 Week 5 rubric: what full points look like
Rows where the replacement is a warning instead of a finding drain this assignment fastest, because a note that appearance may differ leaves the description where it started. One substitution applied down the whole column regardless of site is the next deduction. An audit that reports only the terms it faulted loses the coverage rows, since nothing shows the rest were examined. Further losses come from a skin tone scale named and then used as a label rather than as a reason to look for other features, from replacements that cannot be checked by a second examiner, from evidence about representation missing or uncited and from no account of what the rewrite changes. Full credit goes to audits that reproduce the original, name each assumption, replace it with an observable property, vary by site, list surviving terms and tie the result to care.
PA 510 Week 5 help from the desk
Skin tone audits can feel uncomfortable to write, and the common result is a list of cautions instead of better descriptions. If you share the note or description your section supplied, we can help you name the assumption behind each term and find an observable property to replace it, such as elevation, warmth or scale. We can also help you set up the three-column table, decide where a substitution must change by body site and list the terms that held up. Locating sound evidence on skin tone in teaching images, and citing it correctly, is also within reach. Every judgment in the audit stays your own. When the instructions call for a rewritten description rather than a table, the custom sample delivers the rewrite with the assumptions explained alongside it.
Get a PA-510 Week 5 example written to your instructions
Send the descriptions your section supplied, the rubric, and any tone scale your classroom named. A custom audit built on that exact source, row by row, with replacements written as observations rather than cautions, comes back within 24-48h and the first request costs nothing at all.
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PA 510 Week 5 questions, answered
Which terms usually end up flagged?
Color words doing structural work are the common group, along with anything phrased as a comparison to one default appearance. Sections differ on how far the list runs and some publish it. The audit is marked on the reasoning inside each row rather than on catching a particular set, so a defended row about an unexpected term scores as well as an obvious one.
Does the audit need its own images?
Not usually. The object being examined is the writing, and most sections supply the source deliberately so that everyone audits the same paragraphs. Where images are issued as well they exist to test a replacement, not to be described from scratch. Send whatever your classroom posted and the sample is built on that material alone.
Ours asks for a rewritten description instead of a table. Is it the same work?
The same reasoning, delivered differently. A rewrite still has to show which terms moved and why, so the finished version usually carries a short commentary underneath or marks the changed wording in place. Handing in a clean paragraph with no account of the changes loses the rows that were meant to carry the whole argument.
Where can I find a free PA 510 Week 5 sample paper?
This page has a full PA 510 Week 5 audit of an urgent care note that called a rash on dark brown skin "mildly erythematous," with a term-by-term table.
What replaces "no erythema" in the PA 510 Week 5 sample?
Observable findings: warmer plaque borders to the back of the hand, violet-brown papules at the edges and severe itch reported by the patient.