Skin Idea: Mad Doctor Zed
I think Zed could use a skin to fit other ninjas' medical theme. But make it like a crazed doctor to differentiate him (think Dr. Zed from Borderlands).
Looks: He'd be overly messy to portray his craziness, as well as to differentiate him from other ninjas. Medical robe would be blood-stained. His weapons would be changed to a crude makeshift ejection mechanism with bonesaws. On his back he'd carry huge syringes instead of shurikens that he'd use for his Q.
Particles: Syringes for his Q. Bloody particles for E. Ultimate brings out a pulsing EKG line over his target's head (instead of current 'X') which goes flatline once target's HP reaches the kill threshold.