Besides the 'National Caramel' on E220 backs versus 'American Caramel seen on E122 backs, the E122 American card fronts have a coarse, cross hatch image (that I personally dislike in comparison to the clear photos seen in the E220 National Caramel set).
Here are a couple of E122 American cards as examples to compare with the previously shown E220 National Caramels (cards not mine).
Brian
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