I think it's as you said, the Altered qualifier is a superset of the Trimmed one, so could include trimming, recoloring, attempted erasure of marks, rebuilt corners, etc. Sometimes there are cards that are marked Authentic w/o either the Altered or Trimmed, but that could also mean there is trimming, etc, similar to Altered, or just that the card is so worn down and beat up that it didn't even merit the Poor grade.
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