Patient presents with nail dystrophy, characterized by [specific abnormality observed, e.g., onycholysis, pitting, thickening, discoloration, splitting, ridging, Beau's lines, koilonychia, leukonychia, onychorrhexis, or onychoschizia].  The affected nails include [specify location, e.g., fingernails, toenails, specific digits].  Onset of nail changes was [timeframe, e.g., gradual over several months, acute onset two weeks ago].  Patient reports [associated symptoms, e.g., pain, tenderness, fragility, catching on clothing, difficulty with daily activities].  Review of systems pertinent negatives include [relevant negatives, e.g., no skin rash, no joint pain, no history of psoriasis, no recent trauma].  Medical history includes [relevant medical history, e.g., diabetes mellitus, hypothyroidism, anemia, peripheral vascular disease, fungal infections, Raynaud's phenomenon].  Medications include [list medications].  Family history is notable for [relevant family history, e.g., psoriasis, nail disorders].  Differential diagnosis includes fungal nail infection, psoriasis, lichen planus, trauma, vitamin deficiency, and systemic disease.  Plan includes [diagnostic tests if indicated, e.g., KOH prep, fungal culture, nail biopsy].  Treatment plan includes [treatment recommendations, e.g., topical antifungal medication if indicated, nail clipping and filing, patient education on nail care, referral to dermatologist if necessary].  Patient education provided on proper nail hygiene, avoidance of trauma, and the importance of follow-up.  ICD-10 code [appropriate ICD-10 code, e.g., L60.0, L60.8, L60.9] is considered.  Return to clinic scheduled for [follow-up timeframe].