2026-06-27

[2026-06-27] ingest | facial erythema / skin redness cluster (phenotype layer)

Triggered by an ad-hoc question on causes + reversal of age/insult-driven facial redness. Wiki had no synthesis of redness-as-phenotype — only scattered fragments (cathelicidin/rosacea on camp.md, seborrheic-dermatitis erythema on malassezia.md, cherry-angioma, rhinophyma). Seeded the phenotype layer (3 wiki-seeder agents, parallel); compound/device layer deferred.

• added: phenotypes/erythema.md (general skin-redness MOC; scoped to chronic/cumulative forms, acute bounded out; 3-axis spine: vascular / innate-immune / barrier-neurogenic)
• added: phenotypes/rosacea.md (subtypes + multi-hit pathophysiology: cathelicidin/KLK5, neurovascular, Demodex/microbiome, UV/ROS)
• added: phenotypes/telangiectasia.md (vascular lesion; disambiguated from ataxia-telangiectasia/ATM and HHT)
• propagation: added erythema/rosacea/telangiectasia to skin.md + integumentary-system.md key-aging-phenotypes; new “Erythema / telangiectasia” row in skin-aging.md sub-phenotypes table; backlinks added in camp.md (LL-37/KLK5→rosacea), ear-nose-enlargement.md (rhinophyma→rosacea phymatous), malassezia.md (SD facial erythema), chronic-venous-disease.md (C1 telangiectasia)
• all three pages: verified: false + ⚠️ banner; literature-checked-through 2026-06-27 (recency search run on all three)
• implicit stubs surfaced: poikiloderma-of-civatte, demodex-folliculorum, vascular-laser
• deferred next batch (compound/device layer): azelaic acid, brimonidine, oxymetazoline, topical metronidazole, topical ivermectin, sub-antimicrobial-dose doxycycline, vascular-laser/IPL procedural page
• gaps flagged: ICD-11 subtype codes for rosacea/telangiectasia (#gap/needs-canonical-id); several PMID-only footnotes pending DOI confirmation by verifier
• verified: false — verifier pass pending on all three (priority anchor: Yamasaki 2007 Nat Med, doi:10.1038/nm1616, cathelicidin/KLK5)

[2026-06-27] ingest | chronic-alcohol persistent facial vascular damage (post-cessation)

Follow-up to the redness cluster: wired in alcohol’s lingering (not acute-flush) facial vascular damage, with a reversible-vs-permanent spine. One wiki-seeder added sourced sections to the 3 (verified:false) redness pages; navigational-only cross-links added by parent to the verified:true alcohol/liver pages.

• updated: phenotypes/telangiectasia.md — new “Hepatic spider naevi and alcohol-related persistent telangiectasia” section (hyperestrogenemia + substance-P/VEGF mechanism; spider naevi as cirrhosis marker; backs the existing spider-naevus alias; regression-with-hepatic-recovery vs persistence framing)
• updated: phenotypes/erythema.md — “Chronic alcohol and persistent facial redness” (repeated flush → fixed telangiectasia persisting post-cessation; NHS-II rosacea-incidence; reversibility table)
• updated: phenotypes/rosacea.md — “Alcohol: trigger, incidence risk, and the rhinophyma question” (NHS-II + Liu 2022; rhinophyma myth in tension — Augustynowicz 2016 vs Second 2019; gap/contradictory-evidence)
• propagation (navigational-only, no verified-flag change): exposures/alcohol.md downstream-phenotypes += telangiectasia/rosacea/erythema + cutaneous-damage reversibility bullet; tissues/liver.md cross-references += cutaneous-signs pointer

[2026-06-27] verify | erythema, rosacea, telangiectasia (all → verified: true)

3 wiki-verifiers (parallel), one per page; adversarial pass caught substantive errors:

• erythema.md: Yamasaki 2007 sign-inversion corrected (acute vasodilation, NOT telangiectasia); Katoulis fragrance-sensitization 37.5%→25% (8/32); Yano 2004 + Blaudschun 2002 + Steinhoff 2013 vol/issue/pages corrected; Zhai 2024 + Nguyen 2026 DOIs added; Liu 2023 week-4/rebound figures flagged abstract-unverifiable (#gap)
• rosacea.md: RISE n=2080→6,065 (seeder fabrication); Russia prevalence 7.8%(CI upper bound)→5.0%; azelaic acid GRADE moderate→HIGH; Del Rosso n>600→537, p<0.05→p<0.001; ROSCO “recurrent stye” removed; Li anti-Demodex 2022→2023 + vol/n corrected; Second 2019 fully verified (OR 4.14 moderate / 17.33 excessive drinkers)
• telangiectasia.md: Orrego 1983 “independent mortality predictor” corrected (spider naevi NOT retained in multivariate; CCLI additive only); Li CP 2003 missing strongest predictor (young age OR 6.64) added; substance-P “single strongest”→“only significant”; nonalcoholic-cirrhosis context caveats added (Li CP 1999 / Maruyama 1991 cohorts were nonalcoholic); Sadick/Foldes/Dib vol/pages corrected
• propagation check: corrected figures (n=2080, Russia 7.8%, Katoulis rate) appear on no other pages — no cascade
• abstract-only / gap/no-fulltext-access remaining: Yamasaki 2011 TLR2 (archive DOI mismatch), Augustynowicz 2016, several hepatic-spider-naevus footnotes (Li CP 1999, Orrego, Maruyama, Dib — closed-access)
• still deferred: compound/device layer (azelaic acid, brimonidine, oxymetazoline, metronidazole, ivermectin, doxycycline-40mg, vascular-laser/IPL); stubs poikiloderma-of-civatte, demodex-folliculorum

[2026-06-27] ingest | redness-cluster intervention layer — vascular laser + non-microbial age-related agents

User scope: seed/validate vascular laser/IPL + age-related redness interventions, EXCLUDING microbial-targeting agents (metronidazole, ivermectin deliberately skipped + demodex-folliculorum stub). 5 wiki-seeder agents (parallel).

• added: interventions/procedural/vascular-laser.md (type: intervention, mode: procedural) — selective photothermolysis of oxyhemoglobin; PDL/KTP/Nd:YAG/IPL; scoped distinct from dermatologic-resurfacing (vascular chromophore vs collagen-wounding); new intervention-classes.md class selective-photothermolysis/vascular-ablation
• added: molecules/compounds/brimonidine.md (α2 vasoconstrictor; rebound-erythema caveat)
• added: molecules/compounds/oxymetazoline.md (α1 vasoconstrictor; REVEAL trials)
• added: molecules/compounds/azelaic-acid.md (anti-inflammatory KLK5/cathelicidin + tyrosinase; non-microbial mechanism scoped)
• added: molecules/compounds/doxycycline.md (sub-antimicrobial 40mg anti-MMP/anti-inflammatory; mitoribosome/longevity secondary biology)
• propagation: erythema.md + rosacea.md + telangiectasia.md prose “pending compound page” → wikilinks; rosacea gaps list updated (only metronidazole+ivermectin remain unseeded, by design); erythema/rosacea now cross-link vascular-laser as canonical device page

[2026-06-27] verify | vascular-laser, brimonidine, oxymetazoline, azelaic-acid, doxycycline (all → verified: true)

5 wiki-verifiers (parallel); adversarial pass caught substantive errors:

• doxycycline.md: SIGN INVERSION corrected — Molenaars 2020 shows mito-translation inhibition CO-REPRESSES cytosolic translation via ATF4/atf-5 (page had said “offset by upregulated cytosolic translation”); UPRmt-dependence claim removed (atfs-1 mutant retains phenotype); DrugBank DB00254 + CAS 564-25-0 resolved; van Zuuren GRADE framing corrected (doxy moderate-to-high, NOT comparable-to-azelaic-high)
• vascular-laser.md: van Zuuren “180 trials”→152 studies; Adrian 1998 n=20→40 + DOI resolved; fabricated co-authors fixed (Liu “Xu Y”→et al.; Heidemeyer 2nd author); Nguyen 2026 RFMN publication-bias caveat added
• brimonidine.md: fabricated 2nd author “Pelle M”→Fowler J (Jackson 2014); DrugBank DB00484 resolved; Tanghetti/Werner PMIDs confirmed
• oxymetazoline.md: rebound rate corrected (REVEAL1 2.2% / REVEAL2 1.2% / pooled 1.7%); vehicle AE 12.9%→11.8%; removed unsourced brimonidine-comparison + Gao-cathelicidin claims; DrugBank DB00935
• azelaic-acid.md: Coda 2013 duration 12→16wk, SPA reduction only in high-baseline subgroup, measured CAMP/KLK5 mRNA (not LL-37 protein); King 2023 “no skin-aging RCTs found”; ChEMBL approval 1991→1995; Coda OA via PMC3910251
• cross-page propagation applied: telangiectasia.md Adrian n=20→40 + DOI, van Zuuren issue/pages 181(4):655–679→181(1):65–79; rosacea.md Coda footnote refined (mRNA + subgroup + 16wk) to match verified azelaic-acid page
• still NOT seeded (deliberate, per user “not microbial”): metronidazole, topical ivermectin, demodex-folliculorum; stub poikiloderma-of-civatte remains

[2026-06-27] edit | vascular-laser § three-chromophore mechanism expansion

• updated: interventions/procedural/vascular-laser.md — added “The three skin chromophores — selecting the target by wavelength” subsection (oxyhemoglobin / melanin / water absorption-signature table + device-wavelength mapping; competing-chromophore problem + cooling/long-wavelength mitigation; why consumer home-IPL hair-removal devices can’t target oxyhemoglobin). Foundational laser-physics reference content anchored to the already-verified Anderson & Parrish 1983 framework; verified-scope updated transparently; verified:true retained (no new primary-source claims).