Applicability of Facial De-Identification Methods for Privacy Protection in Dermatology: Systematic Review (Preprint)
BACKGROUND De-identifying facial images is critical for protecting patient anonymity in the era of increasing tools for automatic image analysis in dermatology. OBJECTIVE The purpose of this paper was to review the current literature in the field of automatic facial de-identification algorithms. METHODS We conducted a systematic search using a combination of headings and keywords to encompass the concepts of facial de-identification and privacy preservation. The databases MEDLINE (via Pubmed), Embase (via Elsevier) and Web of Science (via Clarivate) were queried from inception to 5/1/2021. Studies of wrong design and outcomes were excluded during the screening and review process. RESULTS A total of 18 studies were included in the final review reporting various methodologies of facial de-identification algorithms. The study methods were rated individually for their utility for use cases in dermatology pertaining to skin color/pigmentation and texture preservation, data utility, and human detection. Most studies notable in the literature address feature preservation while sacrificing skin color and texture. CONCLUSIONS Facial de-identification algorithms are sparse and inadequate to preserve both facial features and skin pigmentation/texture quality in facial photographs. A novel approach is needed to ensure greater patient anonymity, while increasing data access for automated image analysis in dermatology for improved patient care.