I've been experimenting with a portrait style similar to this lately. Super raw portraits that show every flaw, and yet still manage to really capture the beauty and intensity of the subject. This is one of the best examples I've seen. Usually portraits in this style tend to go with people who have a lot of texture to their skin, this takes it the other way and brings out the details of someone who has nice smooth skin with a hint of freckles. I can only imagine what the unprocessed image looked like. I certainly have to step up my game on my attempts at this now. I will be putting up a tutorial in the future on how to light, shoot, and process shots similar to these (albeit mine will be sans-ringlight).