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A nonblinded randomized trial was conducted at two Canadian provincial outpatient addiction clinics that tested the effectiveness of a systemic congruence couple therapy (CCT) versus individual-based treatment-as-usual (TAU) on nine clinical outcomes: (1) primary outcomes-alcohol use and gambling, psychiatric symptoms, and couple adjustment; (2) secondary outcomes-emotion regulation, substance use, depression, post-traumatic stress symptoms, and life stress. Data of primary clients and partners (N = 46) were analyzed longitudinally across baseline, posttreatment (5 months), and follow-up (8 months). Alcohol use disorder (95%) and gambling disorder (5%) were in the severe range at baseline, and co-addiction was 27%. Psychiatric comorbidity was 100%, and 18% of couples were jointly addicted. Between-group comparison favored CCT in primary outcomes with medium-to-large effect sizes (Cohen's h = 0.74-1.44). Secondary outcomes were also significantly stronger for CCT (Cohen's h = 0.27-1.53). Within-group, for all primary outcomes, a significant proportion of symptomatic CCT clients and partners improved, converging with ANOVA results of large effect sizes (0.14-0.29). All secondary outcomes improved significantly in CCT with large effect sizes (0.14-0.50). TAU showed significant within-group improvement in alcohol use, other substance use, and life stress with large effect sizes (0.16-0.40). Primary clients and partners made largely equivalent improvement within CCT and within TAU. Results were triangulated with clients' satisfaction ratings and counselors' reports. Overall, significant within-group effects were detected for CCT both clinically and statistically and between-group difference favored CCT. Future trials are required to validate these promising findings.本研究对加拿大的两个省级门诊诊所进行了一项非盲法随机试验，测试了系统一致性伴侣疗法(CCT)与基于个体的常规治疗(TAU)在九个临床结果上的有效性: (1)主要结果--酒精使用和赌博、精神症状和伴侣适应; (2) 次要结果-- 情绪调节、药物使用、抑郁、创伤后应激障碍(PTSD)和生活压力。本研究对46例数据进行基线、治疗后(5个月)和随访(8个月)的纵向分析。酒精使用障碍(95%)和赌博障碍(5%)属于严重范围，共同成瘾为27%。精神疾病共病率为100%，共同成瘾夫妇为18%。在组内，有症状的CCT患者和伴侣在所有主要结果上都有改善(效应量= 0.07-0.26)，与大效应量的方差分析结果(效应量= 0.14-0.29) 趋同。所有次要结果在CCT中均有显著改善，且效应量较大(效应量= 0.14-0.50)。TAU在酒精使用、其他物质使用和生活压力方面有显著组内改善，效应量较大(效应量= 0.16-0.40)。在组间比较中，CCT对主要结果具有中到大的效应量(Cohen’s h效应量= 0.74-1.44)。CCT的次要结果也明显更强(Cohen h效应量= 0.27-1.53)。主要来访者和其伴侣与CCT进行了同等的改进。研究结果与来访者满意度评分和咨询师报告进行了三角分析。临床和统计学上均检测到CCT的显着组内效应，组间差异有利于CCT。需要未来的试验来验证这些有希望的发现。.

We report a case of a 13-year-old boy who presented with eruptive monomorphic white papules on the trunk and arms involving regions previously affected by toxic epidermal necrolysis (TEN). Biopsy revealed compact keratin involving the hair follicle and sparse mixed perivascular infiltrate, findings consistent with lichen spinulosus. Improvement was noted after treatment with ammonium lactate 12% lotion. While cutaneous dyschromia and xerosis are common after TEN, lichen spinulosus has not yet been described in the literature. It is important for providers to be aware of any potential cutaneous sequelae of TEN that can affect quality of life in order to best counsel their patients.

Addiction is a severe social and mental health problem that requires concerted interdisciplinary efforts to address. Social workers routinely encounter addiction in their practice and can play an i...

An examination of the interaction of pre- and post-migration stressors is critical to understanding Canadian Muslim immigrant women’s experience of intimate partner violence (IPV). This study uses a dominant qualitative design, supplemented by quantitative data to understand eight Canadian Muslim immigrant women’s experience of IPV from six countries of origin. Five themes were identified: (a) childhood exposure to trauma and violence, (b) iron cage of society, (c) the fusion of love and violence, (d) post-migration challenges and assistance, and (e) toll and consequences of IPV. These themes are described to illustrate the trajectory in the development of IPV and the participants’ eventual decision to leave their relationship. Pre-migration experiences included adverse childhood experiences, family history of IPV, and difficulty with help-seeking for IPV. Post-migration challenges of language difficulties, lack of social connections, internalized familial patriarchal values, and sexism influenced women’s help-seeking and decision-making. Results from this sample suggested that immigrant Muslim women are likely more affected by IPV in comparison to Canadian-born Muslim women, experienced more stressors, less support, delayed help-seeking process, and more serious mental health consequences. Quantitative measures revealed negative effects of IPV on women’s mental and overall health. The roles of ethnic communities, religious institutions, law enforcement, and service providers in supporting Canadian Muslim women with experience of IPV are discussed.

Enfortumab vedotin is an antibody-drug conjugate used for treatment of urothelial cancer. It has recently been associated with several reports of Stevens Johnson syndrome/toxic epidermal necrolysis (TEN). In this report, we describe the case of a 63-year-old man who developed widespread, near full-thickness desquamation, clinically mimicking TEN but with histologic features of toxic erythema of chemotherapy. This distinction is significant because it may have implications for prognosis and treatment. Further investigation is needed to ascertain the incidence of true TEN versus clinical imitators in patients with enfortumab vedotin-related cutaneous toxicity.

Study of change mechanisms is important to advance theory development and to reveal the active components that make a critical difference in treatment. Improved outcomes in a randomized controlled trial that favored Congruence Couple Therapy (CCT) vs individual-based Treatment-as-Usual (TAU) were correlated within each group. Partial correlations were used to test for mediation effects. The aggregate correlation coefficient of improved variables in addiction and mental health, couple adjustment, emotion regulation (ER) and life stress was moderate for CCT and weak for TAU. CCT showed greater number of mediating effects among improved variables than TAU. The prominence of the process mechanism of improved ER with its mediating effects for addiction and psychiatric symptoms evidenced in both groups is noteworthy, but ER improvement was significantly associated with improved couple adjustment only in CCT. Reduction in life stress in CCT was associated with a broader range of improvements in CCT compared to TAU. Correlation patterns were substantiated by CCT participants' endorsement of treatment targets emphasizing relationship, communication, emotion, problem solving, addiction and intergenerational issues of trauma. TAU participants reported significantly lower endorsements for these treatment targets. The correlation of ER and couple adjustment suggested as a key process mechanism should be further elucidated in future studies to differentiate relationship-based vs individual-based models and their respective outcomes for primary clients and partners. These findings are considered preliminary, requiring larger samples and advanced modelling among variables to provide a more profound mechanism analysis.对改变机制的研究对于推进理论和揭示治疗中起关键作用的活性成分具有重要意义。在一项随机对照试验中，一致性伴侣治疗(CCT)与以个体为基础的、有利于CCT的治疗(TAU)的9项改善结果在每组中都是相关的。情绪调节和伴侣关系调整被认为是过程结果，酗酒、赌博和药物使用和精神症状被认为是临床结果，生活压力被认为是社会情境造成的结果。部分相关性用于测试中介效应。CCT改善后的结果的综合相关系数为中等，而TAU改善预后的综合相关系数为微弱。与TAU相比，CCT在改善变量间表现出更多的中介效应。在CCT中，ER改善的过程变量及其对成瘾和精神症状的中介作用的显著性值得注意，ER改善与伴侣适应改善显著相关。ER和伴侣调整改善在TAU中不相关。在以伴侣为基础的CCT干预中，高参与者对强调与成瘾相关的关系和沟通、情感、代际创伤的治疗目标的高度认可证实了相关性模式。TAU参与者报告说，他们对这些治疗目标的认可明显降低。作为上下文变量，压力减少与CCT的其他改善的相关性高于TAU。相关的ER和偶对调整改进表明，它们可能是CCT区别于TAU的关键过程机制。这些发现被认为是初步的，需要更大的样本和先进的模型之间的变量，以提供更深刻的机制分析。.

Actual and perceptual measures of gambling exposure are important predictors of problem gambling. This study used Zero-Inflated Poisson regression analyses to assess the relative and interactive effects of actual and perceived exposure on problem gambling risk and severity. Data from the 2008 and 2009 Social and Economic Impacts of Gambling in Alberta surveys indicated actual exposure was significantly associated with problem gambling risk while perceived exposure was significantly associated with problem gambling severity. These associations differ for gamblers from emerging and mature areas. Further, actual and perceived exposure had significant interaction effects on problem gambling severity but not on risk. Implications from these findings suggest that the prevalence of problem gambling could be reduced by restrictions on gambling opportunities.

Author(s): Mehrabi, Joseph N; Baugh, Erica G; Fast, Alexander; Lentsch, Griffin; Balu, Mihaela; Lee, Bonnie A; Kelly, Kristen M | Abstract: Background and objectivesNon-invasive optical imaging has the potential to provide a diagnosis without the need for biopsy. One such technology is reflectance confocal microscopy (RCM), which uses low power, near-infrared laser light to enable real-time in vivo visualization of superficial human skin from the epidermis down to the papillary dermis. AlthoughnRCM has great potential as a diagnostic tool, there is a need for the development of reliable image analysis programs, as acquired grayscale images can be difficult and time-consuming to visually assess. The purpose of this review is to provide a clinical perspective on the current state of artificial intelligence (AI) for the analysis and diagnostic utility of RCM imaging.Study design/materials and methodsA systematic PubMed search was conducted with additional relevant literature obtained from reference lists.ResultsAlgorithms used for skin stratification, classification of pigmented lesions, and the quantification of photoaging were reviewed. Image segmentation, statistical methods, and machine learning techniques are among the most common methods used to analyze RCM image stacks. The poor visual contrast within RCM images and difficulty navigating image stacks were mediated by machine learning algorithms, which allowed the identification of specific skin layers.ConclusionsAI analysis of RCM images has the potential to increase the clinical utility of this emerging technology. A number of different techniques have been utilized but further refinements are necessary to allow consistent accurate assessments for diagnosis. The automated detection of skin cancers requires more development, but future applications are truly boundless, and it is compelling to envision the role that AI will have in the practice of dermatology. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Sex and gender differences are seen in cognitive disturbances in a variety of neurological and psychiatry diseases. Men are more likely to have cognitive symptoms in schizophrenia whereas women are more likely to have more severe cognitive symptoms with major depressive disorder and Alzheimer's disease. Thus, it is important to understand sex and gender differences in underlying cognitive abilities with and without disease. Sex differences are noted in performance across various cognitive domains - with males typically outperforming females in spatial tasks and females typically outperforming males in verbal tasks. Furthermore, there are striking sex differences in brain networks that are activated during cognitive tasks and in learning strategies. Although rarely studied, there are also sex differences in the trajectory of cognitive aging. It is important to pay attention to these sex differences as they inform researchers of potential differences in resilience to age-related cognitive decline and underlying mechanisms for both healthy and pathological cognitive aging, depending on sex. We review literature on the progressive neurodegenerative disorder, Alzheimer's disease, as an example of pathological cognitive aging in which human females show greater lifetime risk, neuropathology, and cognitive impairment, compared to human males. Not surprisingly, the relationships between sex and cognition, cognitive aging, and Alzheimer's disease are nuanced and multifaceted. As such, this chapter will end with a discussion of lifestyle factors, like education and diet, as modifiable factors that can alter cognitive aging by sex. Understanding how cognition changes across age and contributing factors, like sex differences, will be essential to improving care for older adults.

Measures of availability and accessibility are often used separately or interchangeably to assess gambling exposure. This study examined the advantages of assessing gambling exposure using availability, accessibility, and a composite measure. Logistic and poisson regression analyses were used to determine the relative importance of these measures in predicting problem gambling using data from the 2008 and 2009 Social and Economic Impacts of Gambling in Alberta (SEIGA) surveys. The composite measure of gambling exposure predicted both the risk and severity of problem gambling better than the availability or accessibility measures alone. These results demonstrate that individual differences in problem gambling are better predicted by a composite measure of exposure.

Couple and family relationships are central in processes of substance use and gambling disorders, yet they remain inadequately researched and marginally addressed in services found in the health system. Multiple barriers exist that favour a focus on the individual due to organization structure and discourse, shortage of couple therapy training, and values and philosophy of addiction services. This article describes a successful strategic initiative to foster a partnership for researchers and health system decision-makers to promote a health system change. We identify impactful factors in a two-day integrated knowledge translation workshop bringing together practitioners, researchers, decision-makers and couples seeking services for gambling and substance use disorders. The initiative shifted awareness of decision-makers, built a network of collaborative relationships and created a consensus for action among stakeholders. This early integrated knowledge translation strategy opened up research partnership on a couple therapy randomized trial in the health system, training for counselors, and research opportunities for graduate students.

The aim of this study was to determine the moderating effects of sociodemographic characteristics, substance use, and psychosocial problems on the relationship between perceived gambling availability and problem gambling severity. Bivariate and multivariate regression analyses of the 2008 and 2009 Social and Economic Impacts of Gambling in Alberta surveys found problem gambling severity was 1.25-1.39 times higher for those reporting gambling opportunities were 'too widely available'. Factors such as age, gender, place of residence, and psychosocial problems had significant moderating effects. Our findings indicate that the perception of gambling availability has a statistically significant impact on problem gambling severity.

This article explicates the analogous principles and concepts between traditional Chinese medicine (TCM) and congruence couple therapy (CCT). Although originating out of vastly different times and places, TCM and CCT share a view of health based on systems understanding to facilitate the interconnections of the parts of an organism rather than focusing on eliminating symptoms. Both approaches aim to release Qi(气) and vitality by removing blockages through adjusting the interactions, adaptation, and balance of multiple elements and Yin-Yang energies. The goal is to liberate the Qi or life force through improved holistic balance and cooperation. While TCM focuses on interventions at the level of the body, CCT focuses on the attention, awareness, acknowledgement, and alignment of the four human dimensions consisting of the intrapsychic, interpersonal, intergenerational, and universal-spiritual. In light of the current trend toward increasing mental, substance use, and neurological disorders, in particular among countries of middle and low income, dialogue to explore these compatibilities between TCM and CCT is conducive to the continuous evolution of TCM and Western therapies to address not only physical health but also the exigencies of contemporary addiction and mental health care within a mind–body relationship matrix.

Adult neurogenesis modifies hippocampal circuits and behavior, but removing newborn neurons does not consistently alter spatial processing, a core function of the hippocampus. Additionally, little is known about sex differences in neurogenesis since few studies have compared males and females. Since adult-born neurons regulate the stress response, we hypothesized that spatial functions may be more prominent under aversive conditions and may differ between males and females given sex differences in stress responding. We therefore trained intact and neurogenesis-deficient rats in the spatial water maze at temperatures that vary in their degree of aversiveness. In the standard water maze, ablating neurogenesis did not alter spatial learning in either sex. However, in cold water, ablating neurogenesis had divergent sex-dependent effects: relative to intact rats, male neurogenesis-deficient rats were slower to escape the maze and female neurogenesis-deficient rats were faster. Neurogenesis promoted temperature-related changes in search strategy in females, but it promoted search strategy stability in males. Females displayed greater recruitment (Fos expression) of the dorsal hippocampus than males, particularly in cold water. However, blocking neurogenesis did not alter Fos expression in either sex. Finally, morphologic analyses revealed greater experience-dependent plasticity in males. Adult-born neurons in males and females had similar morphology at baseline but training increased spine density and reduced presynaptic terminal size, specifically in males. Collectively, these findings indicate that adult-born neurons contribute to spatial learning in stressful conditions and they provide new evidence for sex differences in their behavioral functions.

Adult hippocampal neurogenesis has been implicated in the spatial processing functions of the hippocampus but ablating neurogenesis does not consistently lead to behavioral deficits in spatial tasks. Parallel studies have shown that adult-born neurons also regulate behavioral responses to stressful and aversive stimuli. We therefore hypothesized that spatial functions of adult-born neurons may be more prominent under conditions of stress, and may differ between males and females given established sex differences in stress responding. To test this we trained intact and neurogenesis-deficient rats in the spatial water maze at temperatures that vary in their degree of aversiveness. At standard temperatures (25°C) ablating neurogenesis did not alter learning and memory in either sex, consistent with prior work. However, in cold water (16°C), ablating neurogenesis had divergent sex-dependent effects: relative to intact rats, male neurogenesis-deficient rats were slower to escape and female neurogenesis-deficient rats were faster. Neurogenesis promoted temperature-related changes in search strategy in females, but it promoted search strategy stability in males. Females displayed greater recruitment of the dorsal hippocampus than males, particularly at 16°C. However, blocking neurogenesis did not alter activity-dependent immediate-early gene expression in either sex. Finally, morphological analyses of retrovirally-labelled neurons revealed greater experience-dependent plasticity in new neurons in males. Neurons had comparable morphology in untrained rats but 16°C training increased spine density, and 25°C training caused shrinkage of mossy fiber presynaptic terminals, specifically in males. Collectively, these findings indicate that neurogenesis functions in memory are prominent under conditions of stress, they provide the first evidence for sex differences in the behavioral function of newborn neurons, and they suggest possibly distinct roles for neurogenesis in cognition and mental health in males and females.

Purpose: Employment and family/social relationships are 2 of the highest priorities among those in substance use recovery. This study examined the relationship of work status with couple adjustment and other recovery capital treatment outcomes among symptomatic alcohol, substance use, and gambling participants ( N = 38) using data collected in a randomized trial comparing a systemic Congruence Couple Therapy (CCT) and individual-based Treatment-as-Usual (TAU). Method: Change scores and associations between work status and couple adjustment together with 8 other recovery outcome variables at post-treatment (5 months from baseline) and follow-up (8 months from baseline) in TAU ( n = 17) and CCT ( n = 21) were analyzed. Results: Number of those working increased with both CCT and TAU but without reaching significance in either CCT (Cochran’s Q = 5.429, P = .066) or TAU (Cochran’s Q = 2.800, P = .247). Relative to those not working in the combined sample, those working showed significantly improved scores in post-treatment and follow-up in addictive symptoms, couple adjustment, psychiatric symptoms, depression, and life stress. Separating the CCT and TAU groups, similar trend was found in the CCT group but was inconsistent in the TAU group. Conclusion: Significantly greater improvement in addictive symptoms and recovery capital of couple adjustment, mental health, and life stress was found in the working vs not-working group. Compared to individual-based TAU, exploratory findings indicate that the systemic treatment of CCT showed a clearer and more consistent difference in improved working days, addictive symptoms and recovery capital. Replication with larger samples is needed to generalize these results.

Author(s): Dobry, Allison S; Virgen, Cesar Antonio; Hosking, Anna-Marie; Mar, Nataliya; Doan, Linda; Lee, Bonnie; Smith, Janellen

Alzheimer’s disease (AD) is a progressive neurodegenerative brain disorder that features distinctive neuropathology and global impairments to cognition. Sex differences are seen in AD, as females with AD show increased neuropathology and steeper cognitive decline than men with AD but are often neglected in the literature. The hippocampus is one of the first brain areas to be affected by AD, and this area shows a great deal of plasticity in adulthood, including neurogenesis, and is affected by both sex and sex hormones. There are sex differences in the morphology and function of the hippocampus, as well as sex differences in how the hippocampus is impacted in AD. Adult hippocampal neurogenesis has been demonstrated in humans, nonhuman primates, and rodents, and adult-born neurons play an important role in hippocampal function, including stress resilience and learning and memory. Sex hormones also affect neurogenesis and cognition, and hormone therapy has been suggested as a treatment for Alzheimer’s disease in both males and females. This chapter examines sex differences in hippocampal neurogenesis and hippocampus-dependent cognition, in both healthy individuals and in those with AD, and how these differences are affected by age, hormones, APOE genotype, and experience. Understanding the effects of sex and sex hormones on hippocampal plasticity may lead to new therapeutic targets to combat cognitive decline and neuropathology related to AD.

Plasmablastic lymphoma (PBL) is a rare type of non-Hodgkin lymphoma frequently found in the context of immunosuppression and infection with human immunodeficiency virus (HIV) and/or Epstein-Barr virus (EBV). A 33-year-old immunocompetent male presented with recurrent episodes of epistaxis and a growing intranasal mass. Excisional biopsy of the mass revealed an immunohistochemical profile diagnostic of PBL. Upon completion of chemoradiation, he underwent a transnasal endoscopic mucosal flap tissue rearrangement to restore patency for both functional and surveillance purposes. There was no endoscopic evidence of residual or recurrent disease. However, 8 months later, he was found to have a relapse involving the skin. The nasal cavity is one of the most common sites affected by PBL. Involvement of the nasal cavity may present with symptoms of persistent epistaxis accompanied by an enlarging mass. A plasmablastic immunophenotype in combination with HIV or EBV positivity can aid diagnosis.

The histology of erythema (chronicum) migrans (ECM) is classically described as a nonspecific perivascular infiltrate with a variable number of plasma cells and eosinophils. However, deviations from this pattern were described, such as focal interface changes or spongiosis, potentially posing a clinicopathological challenge. In this study, cases submitted with a serologically confirmed, clinically unequivocal, or highly suspicious diagnosis of ECM/Lyme disease between January 01, 2016, and September 01, 2018, were retrieved from the electronic database system and reviewed to delineate the histopathologic features of ECM. The series consisted of 14 cases. A superficial perivascular lymphocytic infiltrate was noted in all biopsies, accompanied by a deep and/or interstitial inflammatory infiltrate in 9 cases (64%). The inflammation ranged from relatively sparse to dense and prominent. At least focal interface changes were noted in 12 biopsies (86%). Eosinophils and plasma cells were noted in 7 (50%) and 10 (71%) cases, respectively. From a histologic standpoint, ECM is a protean entity and may manifest with a variable density of perivascular and/or interstitial lymphocytic infiltrate admixed with eosinophils and/or plasma cells and accompanied by focal interface dermatitis. Within the appropriate clinical context, ECM should be considered in the differential diagnosis of focal interface and/or sparse perivascular dermatitis.

Internationalization of higher education to include international, intercultural, or global components into the delivery of postsecondary education has drawn increasing attention in the last two de...

Purpose Injuries resulting from racism are largely hidden by silence. Community services to provide healing from racism are missing in at least one Canadian city. The purpose of this paper is to identify the injuries suffered by immigrants who experienced racism and discuss the development of culturally appropriate programs and tools to address injuries from racism. Design/methodology/approach Participants representing visible minorities service providers from non-profit, public-funded organizations in a major Canadian city took part in two focus groups. Data from focus groups were thematically analyzed. Findings Racism produces traumatic and persistent psychological, social and intergenerational injuries. An ostensible gap exists in services, professional education and skills to address the psycho-social effects of this complex problem. The complicity of silence in both dominant and subordinated groups contributes to its perpetuation. A dearth of screening and assessment instruments is a barrier in identifying individuals whose mental health and addiction problems may have underlying racism-related etiology. Creation of community healing circles is recommended as a preferred method over individual “treatment” to expose and deconstruct racism, strengthen ethnic identity and intergenerational healing. Research limitations/implications These qualitative findings were generated based on the perspectives of a small purposive sample (n=8) of immigrant service providers and immigrants from one Canadian city. Many of these findings are consistent with the existing literature on internalized racism and racism injuries. Generalizability to the wider population of the province and of Canada requires further research. Practical implications Practitioners in health and social care as well as educators need to understand the injuries and internalized effects of racism to provide appropriate services and leadership. Development of anti-racism professional knowledge and skills, healing circles, and assessment instruments will contribute to deconstructing racism and mitigating its injuries. Originality/value Community-driven studies exploring racism and the lack of services to address the issue are scarce. This study pulls together the experience of service providers and their insights on ways to break the detrimental silence surrounding racism.

Background Distinguishing regressed lichen planus-like keratosis (LPLK) from regressed melanoma can be difficult on histopathologic examination, potentially resulting in mismanagement of patients. Objective We aimed to identify histopathologic features by which regressed melanoma can be differentiated from regressed LPLK. Methods 20 actively inflamed LPLK, 12 LPLK with regression, and 15 melanomas with regression were compared and evaluated by H&E staining as well as Melan-A, MiTF, and cytokeratin (AE1/AE3) immunostaining. Results 1) 40% of regressed melanomas demonstrated complete or near complete loss of melanocytes within the epidermis with Melan-A and MiTF immunostaining, while 8% of regressed LPLK exhibited this finding. 2) Necrotic keratinocytes were seen in the epidermis in 33% regressed melanomas as opposed to all of the regressed LPLK. 3) A dense infiltrate of melanophages in the papillary dermis was seen in 40% of regressed melanomas, a feature not seen in regressed LPLK. Conclusions In summary, our findings suggest that a complete or near complete loss of melanocytes within the epidermis strongly favors a regressed melanoma over a regressed LPLK. Additionally, necrotic epidermal keratinocytes and the presence of a dense band-like distribution of dermal melanophages can be helpful in differentiating these lesions.