To create the skin graphics, you just need a paint program that you're comfortable with. Most people here are using Photoshop, or Paint Shop Pro, among others. As for putting the skin together, that depends on which program you're making a skin for. To make logons, you'll want to use LogonStudio.
You can learn more about the various types of skins and how to make them here: https://www.wincustomize.com/msgboard.asp?BID=WC&id=304555
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