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You must spill 10,000 Pints of blood using every single kombatant(excluding Skarlet)and then view her charcter model in the necropolis(pick a character/press start/go to character select/press Start on Skarlet) I COULDN'T FIGURE WHAT TO DO BUT THEN I REALIZED SHE IS MADE OF BLOOD SO I DID THIS AND IT UNLOCKED THE OUTFIT FOR ME