| Course | PA 510 Comprehensive Clinical Module Dermatology |
|---|---|
| Week | 6 |
| Paper type | Pigmented lesion evaluation |
| Length | About 970 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 6
Pigmented Lesion Evaluation: An 8-Millimeter Brown-Black Spot on the Left Sole, Set Against the Patient's Other Acral Spots and Against the Absence of Any Earlier Record
Student Name
Chamberlain University
PA 510: Comprehensive Clinical Module Dermatology
Instructor Name
Month Day, Year
Pigmented Lesion Evaluation: An 8-Millimeter Brown-Black Spot on the Left Sole, Set Against the Patient's Other Acral Spots and Against the Absence of Any Earlier Record
How It Was Found
During the full skin examination for D.O.'s eruption, a pigmented spot was found on the sole of the left foot, on the weight-bearing area below the base of the second toe. D.O. said, "I didn't know that was there." It is evaluated here on its own, separately from the eruption. Acral lentiginous melanoma, the subtype found on the palms, soles and nails, makes up a larger share of melanomas in Black patients than in any other group in U.S. registry data, 36% (Bradford et al., 2009), which is one reason a new acral spot in this patient is taken seriously.
Features, One at a Time
Symmetry: asymmetric. Folded along its long axis, the two halves do not match in shape or color; the outer half is wider and darker.
Border: irregular. The inner edge is smooth and can be traced; the outer edge is notched, and at one point the pigment fades out gradually so the edge cannot be traced with confidence.
Colors: three. Light brown over most of the inner half; dark brown in a band through the center; and a black area about 2 by 2 millimeters at the outer edge. Each color is recorded with its location, not as a single word.
Size: 8 by 5 millimeters, measured with a flexible clear ruler laid on the skin.
Elevation: flat. No part of it can be felt above the surrounding skin. There is no ulceration, bleeding or crust.
The Rest of the Person's Lesions
D.O. has six other pigmented spots on the palms and soles: three on the right sole, two on the left palm and one on the right palm. Each is 2 to 3 millimeters, uniformly light tan, round or oval, with a smooth border. They look alike. The spot on the left sole is larger, darker, more varied in color and irregular. It differs from the patient's own pattern, the so-called ugly duckling. This comparison is the strongest argument in the evaluation, because it uses the patient as the reference rather than a textbook.
D.O. also has two fingernails with thin, uniform, light brown bands running the length of the nail, a common finding in people with darker skin. They are recorded and are not part of this evaluation.
Change Needs an Earlier Record
D.O. does not know how long the spot has been there. A podiatry note from two years ago, for a callus on the right foot, describes the left foot as "normal" without mentioning the spot. That absence is not evidence that the spot was not there; the note may not have described pigmented spots at all. No photograph of the foot exists. The evaluation therefore records change as unknown, not as present. Claiming change without an earlier record would be inventing a finding.
Measured, and With What
The ruler measurement is recorded. A standardized photograph with a scale was taken today, with diffuse light and no flash, so that any future comparison has a baseline.
Where Dermoscopy Belongs
Dermoscopy was not available in this clinic. On acral skin, it can show patterns with high value for melanoma: pigment along the ridges of the skin markings, called the parallel ridge pattern, had a specificity of 99% for melanoma in a multicenter study of acral lesions, while pigment along the furrows favored a benign nevus (Saida et al., 2004). That examination belongs to the dermatology visit. The evaluation does not guess at what dermoscopy would show.
Risk Factors Asked About
D.O. was asked about previous skin cancers, any family member with melanoma, a history of blistering sunburns and use of tanning beds; all were answered no. Acral melanoma is not strongly tied to sun exposure, so the lack of sunburns does not reduce concern about a lesion on the sole. D.O. was also asked about injury to the foot, since a bruise under thick skin can look black; D.O. works in steel-toe boots and recalled no blow to the sole. Blood under the skin of the sole usually lies in small dots and fades or moves forward over weeks, so a repeat look in two weeks would help separate it, but the decision about urgency does not wait for that.
Summary of the Evaluation
An 8-millimeter, asymmetric, three-colored, irregularly bordered flat pigmented lesion on the weight-bearing sole of a 47-year-old, unlike the patient's other acral spots, with no record of when it appeared. The features and the within-person comparison call for prompt dermatology evaluation with dermoscopy and likely biopsy.
Why the Weight-Bearing Site Matters
The location deserves its own line. The lesion sits under the ball of the foot, which takes pressure through a full warehouse shift. Pressure and friction can change how a pigmented spot looks on the surface and can thicken the skin over it, which makes the color pattern harder to read by eye. It also means that a biopsy site there will be tender for some days, which the patient should hear about early so that time off or a change of duties can be planned if a sample is taken. None of this changes the urgency; it changes the practical advice that goes with the referral.
What This Document Does Not Do
It does not diagnose melanoma, and it does not choose the biopsy method; those belong to the dermatologist. It records findings and comparisons clearly enough that the referral can be prioritized.
References
Bradford, P. T., Goldstein, A. M., McMaster, M. L., & Tucker, M. A. (2009). Acral lentiginous melanoma: Incidence and survival patterns in the United States, 1986-2005. Archives of Dermatology, 145(4), 427-434. https://doi.org/10.1001/archdermatol.2008.609
Saida, T., Miyazaki, A., Oguchi, S., Ishihara, Y., Yamazaki, Y., Murase, S., Yoshikawa, S., Tsuchida, T., Kawabata, Y., & Tamaki, K. (2004). Significance of dermoscopic patterns in detecting malignant melanoma on acral volar skin: Results of a multicenter study in Japan. Archives of Dermatology, 140(10), 1233-1238. https://doi.org/10.1001/archderm.140.10.1233
Reading the PA 510 Week 6 instructions
The sixth week asks you to evaluate a pigmented lesion through two comparisons. First, record its features one at a time: symmetry across an axis, whether the border can be traced, how many colors are present and where each sits, the widest measurement with the instrument used and whether it is flat or raised. Second, compare the lesion with the patient's other pigmented lesions, since a spot that differs from the person's own pattern carries weight. Address change only if an earlier record exists, and say plainly when it does not. Ask about relevant risk factors. Use dermoscopic terms only if dermoscopy was done, and otherwise say where it belongs. Support epidemiologic claims with sources. Finish with a summary that tells the reader how urgently the lesion needs specialist review, without diagnosing it.
How this PA 510 Week 6 example is built
The evaluation opens on the full skin examination at which the spot was found, under the ball of the left foot, and cites registry data showing that acral lentiginous melanoma makes up 36% of melanomas in Black patients. Features follow on separate lines: asymmetric halves, a border smooth on the inner side and notched and fading on the outer, three colors placed by location including a 2-millimeter black zone, 8 by 5 millimeters by flexible ruler and flat on palpation. The comparison with six uniform tan acral spots of 2 to 3 millimeters shows this lesion is unlike the rest. A two-year-old podiatry note that never described the spot is treated as no record, so change is recorded as unknown. A baseline photograph is taken. Dermoscopy is placed at the specialist visit with published pattern data. Risk factor questions and the weight-bearing site get short sections before the summary.
PA 510 Week 6 rubric: what full points look like
A full feature list with nothing set beside it is where this week loses the most, because the comparison rows stay empty while the description rows fill. Change claimed with no earlier record behind it is the next loss, and markers treat it as invention rather than finding. Color reported as one word, when the assignment counts colors and asks where each sits, gives up a straightforward row. Further deductions follow for dermoscopic terms used when no dermoscopy was done, for size given without the instrument, for epidemiology asserted without a source and for an evaluation that names melanoma instead of describing and prioritizing. Strong work records each feature separately, compares the lesion with the patient's own pattern, handles change honestly, asks about risk factors, places dermoscopy correctly and ends with a summary that sets urgency. A baseline photograph taken for future comparison is a sensible addition.
PA 510 Week 6 help: mistakes that cost points
Pigmented lesion evaluations often read as a checklist with no comparison, which is where most marks are lost. If you share the case or images from your section, we can help you record each feature on its own line, count and place the colors and set the lesion against the patient's other spots. We can also help you word the change section honestly when no earlier record exists, and explain where dermoscopy belongs if it was not done. Citing accurate data on acral lesions in patients with darker skin, without overstating it, is another part we can help with. The findings and their summary are yours. If your course uses a published checklist such as the ABCDE features or the seven-point list, the custom sample follows that structure while keeping both comparisons.
Get a PA-510 Week 6 example written to your instructions
Send the case file, the images, the rubric and any form your section issues for this week. A custom evaluation matched to those fields returns within 24-48h with the first request free, and where your material holds no earlier record the sample shows how the write-up states that rather than filling the gap.
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 4: Clinical Photograph Critique
- PA 510 Week 5: Skin Tone Description Audit
- PA 510 Week 7: Biopsy Site Justification
- PA 510 Week 8: Teledermatology Referral Brief
- PA 505 Week 6: Substance Use History Brief
- PA 504 Week 6: Collateral History Brief
- PA 503 Week 6: Assessment and Plan Draft
- PA 502 Week 6: Guideline Comparison
PA 510 Week 6 questions, answered
Does the evaluation have to reach a verdict?
Sections differ, and many ask for a recorded impression rather than a decision. Where a verdict is wanted it sits at the end and rests on the features already listed, not the other way round. Where none is wanted, adding one earns nothing and can crowd out the comparison rows that do carry marks in this week.
Our case file has no earlier photograph. What happens to the change section?
It gets written as an absence, which counts as a finding on most rubrics. The document records that no earlier material was supplied, names what such a record would have settled, and says what would have to be documented from here for the comparison to be possible later. That scores far better than a vague claim about progression.
Can we use a published feature checklist as the structure?
Usually yes, and many sections name one. What gets marked is the reasoning between the items rather than the items themselves, so the finished version records each feature and then says what the set of them, taken together, makes reachable. A checklist reproduced with ticks and no commentary loses the analysis rows outright.
Where can I find a free PA 510 Week 6 sample paper?
You can read the complete PA 510 Week 6 evaluation of a brown-black spot on the sole, compared with the patient's other acral spots, on this page.
Why does the PA 510 Week 6 sample record change as unknown?
Because the only earlier record, a podiatry note, never described pigmented spots, so its silence cannot show the lesion was absent then.