How is impetigo differentiated from tinea capitis (scalp ringworm)?

Updated: Feb 21, 2020
  • Author: Marc Zachary Handler, MD; Chief Editor: Dirk M Elston, MD  more...
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Impetigo may be difficult to distinguish from inflammatory tinea capitis, although pain is less severe in tinea capitis, and hairs tend to be seated firmly in impetigo. Alopecia areata also causes circumscribed areas of hair loss similar to tinea capitis, but alopecia areata does not cause scaling. Lesions may have an erythematous border in the early stages of the disease, but this reverses to normal color at later stages. The exclamation mark hairs seen in alopecia areata, in which broken hairs taper from the fractured end toward the skin surface, are pathognomonic.

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