I've seen cosplay outfits for Silent Hill's nurses before, but nothing as accurately menacing as this. This looks even creepier than the Silent Hill movie poster with the nurses!

Certainly, the performer's contributions -- putting together the grungy uniform/mask, painting veins all over herself, posing awkwardly -- made this Anime Central 2009 photo shoot stand out from other similar costumes, but photographer Judith Stephens should also be applauded for capturing the feel of these video game enemies approaching you, scalpels in hand (or a straight razor in this case).

You can see a couple more nurse photos below, and the rest from the set (including shots of Pyramid Head cosplay) on Stephens' Flickr set: