You can, but don't have to. A lot of people have created themes already and shared them to the world. Some themes were especially created for myPHPNuke, most of the themes are adaptations from themes for other Nuke distro's. They are converted to myPHPNuke.

If you want to create your own themes or you want to adapt existing themes to myPHPNuke 188_8, you definitely need to read this appendix and try to understand which path to follow. In this appendix, Kiril shows us which themes are part of the distro and what their purpose is.