I'm usually a fan of Gayle Feyrer's Trek illustrations - they're quite stylized and often hard-core explicit, and I think she does a good job of capturing the faces of the subjects. But this little gem - well, I can't tell what she's going for here, except TOTALLY BATSHIT INSANE.
I think this is Spock. Suggestions for what's happening here are welcome. It looks to me like he's got measles and is about to be strangled by a huge disembodied hand.