sexy and twisted

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Senior Member
When you call an album cover, drawing or picture of an album, is "sexy and twisted," what does it mean?
Ladygaga, a female singer calls her "Born This Way" album cover sexy and twisted.
I think I understand "sexy" part but I'm not sure what "twisted" in this context means.

After some research, I found out that "sexy and twisted" is often used as a set phrase but don't think I understand it correctly.
Thank you.
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