###### Abstract  
Background: Celiac disease arises from gluten consumption and shares symptoms with other conditions, leading to delayed diagnoses. Untreated celiac disease heightens the risk of autoimmune disorders, neurological issues, and certain cancers like lymphoma while also impacting skin health due to intestinal disruptions. This study uses facial photos to distinguish individuals with celiac disease from those without. Surprisingly, there is a lack of research involving transfer learning for this purpose despite its benefits such as faster training, enhanced performance, and reduced overfitting. While numerous studies exist on endoscopic intestinal photo classification and a few have explored the link between facial morphology measurements and celiac disease, none have concentrated on diagnosing celiac disease through facial photo classification. Methods: This study sought to apply transfer learning techniques with VGG16 to address a gap in research by identifying distinct facial features that differentiate patients with celiac disease from healthy individuals. A dataset containing a total of 200 facial images of adult individuals with and without celiac condition was utilized. Half of the dataset had a ratio of 70% females to 30% males with celiac condition, and the rest had a ratio of 60% females to 40% males without celiac condition. Among those with celiac condition, 28 were newly diagnosed and 72 had been previously diagnosed, with 25 not adhering to a gluten-free diet and 47 partially adhering to such a diet. Results: Utilizing transfer learning, the model achieved a 73% accuracy in classifying the facial images of the patients during testing, with corresponding precision, recall, and F1 score values of 0.54, 0.56, and 0.52, respectively. The training process involved 50,178 parameters, showcasing the model's efficacy in diagnostic image analysis. Conclusions: The model correctly classified approximately three-quarters of the test images. While this is a reasonable level of accuracy, it also suggests that there is room for improvement as the dataset contains images that are inherently difficult to classify even for humans. Increasing the proportion of newly diagnosed patients in the dataset and expanding the dataset size could notably improve the model's efficacy. Despite being the first study in this field, further refinement holds promise for the development of a diagnostic tool for celiac disease using transfer learning in medical image analysis, addressing the lack of prior studies in this area. c 2024 14 6207 14  
extent of damage. However, it typically takes around 4-5 years for physicians to decide to recommend a biopsy. During this time, symptoms worsen and become more challenging [3]. Addressing these limitations requires ongoing research to improve the accuracy and timeliness of CD diagnosis. CD diagnosis is challenging due to its diverse clinical manifestations and symptoms that are shared with other diseases [4]. Delayed diagnosis can exacerbate disease progression and intestinal permeability in its early stages [5]. In the present era, there is a heightened emphasis on discovering automated computational mechanisms that can aid in [6] the determination of intestinal atrophy in celiac disease, but there is a lot less research on the impact of gluten sensitivity on facial appearance. CD is associated with impairments in gut health that can extend to the skin through a variety of mechanisms, including inflammation, immune system changes, and microbiome dysbiosis [7; 8]. The craniofacial morphology of patients with celiac disease has been shown to reveal a distinct pattern of craniofacial growth [9]. Moreover, celiac patients often exhibit distinctive facial features, such as paleness due to anemia, itchy rashes with small blisters around the hairline and mouth (dermatitis herpetiformis), and inflammation and cracking at the corners of the lips (cheilitis) [10].