Twisted the Clown's previous name was unknown. Backstreet chemist & pharmacist during the 1800's supplying hallucinogenics, through an establishment known to the underground as the Stitcheart Academy, which often took in homeless orphans as workers. Particularly her own concoction branded to clients as Stripsychosis.
On one side of her face you will notice she is missing her cheek, revealing most of her teeth. Which, she will not expand upon the origin of the wound, apart from the fact she attempted to crudely stitch it back together herself.
Once joining the acquired supernatural powers and can absorb people into eye shaped, blinking portals named Sicht-Portals (German for sight portals) which transports them to a freakish dimension controlled by her mind. She is a keen seamstress and often used the skin of disposed bodies in particular from the acts of the magician Mr Lamba, and Choke the Clown during the Karnaval period.
She has since kept her current plans, and herself, scarce from the world, as she is able to shift from present consciousness/reality to the nightmare plane. In the last decade, she appears to been affiliated with Papa Lazarou and his Pandemonium Carnival for a time, running Zirkus Der Augen.