My puppy has a small little scaly patch on his ear. I know you can’t diagnose but not sure if this is ringworm? How can you tell if something is ringworm? Mostly what I read was to look for red patch which this is not. I will call vet but not sure if this is a watch and wait thing or ASAP. Thanks!

From the picture you provided, it doesn't appear to be ringworm, but as you said I can't say for sure without seeing him. It could be a bit of dry skin, or a scab from a previous injury. I'd just keep an eye on it for now. If it becomes red, gets larger, and/or doesn't go away, then I would have him seen by a vet. Best of luck, I hope this helps!

You don't mention if your vet did a culture to test for ringworm (this test takes several days so you wouldn't have results back the same day). We do sometimes see ringworm cause a raised nodule/swelling, so it is still possible and I would recommend a culture if one wasn't done. Other possibilities include a skin growth called a histiocytoma, a bacterial infection, ingrown hair, or foreign body. Your vet may also recommend an aspirate of the area to try to determine what is going on. Unfortunately there isn't an over the counter treatment for these.