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This is a great way to take a not so interesting white frosted cake into a masterpiece. It looks like they started with a fondant type frosting base because that is easiest to paint with. I have seen markers that are basically food coloring so they are easier to control than a paintbrush and using markers would be easier for those who don`t have a lot of artistic skills. This person had alot of skill because those roses look so realistic! I love this style of cake because it is so simple (if you have a artistic hand) and makes a really nice looking product.
Image Source: http://fleaingfrance.tumblr.com/post/19719702839/gastrogirl-beautiful-painted-cake