I did a Halflife 2 pumpkin a couple of years ago. I've done a couple of custom pumpkins the past couple of years but I only remember that one. I've never tried anything that would require "art skilz" though. I think carving pumpkins is a ton of fun, but the wife and kids only want to do traditional pumpkins. (yawn...)
I'm still thinking about what to carve this year. I agree the hard part for me is to take an image and photoshop it into a pattern. After you have the pattern, it's not too hard to do a good looking pumpkin as long as it's not too complicated.