The images themselves can come from anywhere. You can use a tool like Photo
Shop to create your own, or there are lots of sites on the internet that have
images you can buy or download for free. With a little modification, web page backgrounds and layouts lend themselves very well to APPX wallpaper and buttons.
You do not need a product like Photo Shop to maintain or store images. As long as the image is the size you want, you need only the image.
If you want to modify the image you will need an editor of some kind. APPX will help you alter an image, although in some cases, such as defining a picture widget, APPX will allow you to scale the image size to fit (in 4.1.4 and after).
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