Masque of the Red Death (1994) is  set in a version of the real world circa 1890 called Gothic Earth, directly inspired by Poe and Stoker and on. It sort of feels like a half-hearted answer to Call of Cthulhu and Vampire: The Masquerade.

It is a variant, one that reworks the core D&D (and Ravenloft) rules into something  resembling a skill-based system that is highly dependent on character kits and the use of (a heavily modified) proficiency system. As I’ve said before, Ravenloft doesn’t work for me as a D&D setting because the horror it seeks to explore is based on helplessness and D&D is mechanically built around the accumulation of power. Those two things are directly at odds and Masque actually recognizes this. In my view, though, it doesn’t recognize this to the logical conclusion – that you need a whole different system for this sort of thing – and winds up with a janky, stripped down version of D&D that is now more deadly but not particularly scary. (It is also not stand-alone – you still need core Ravenloft box set)

There are three adventures that illustrate this. They all have the same basic set-up: the players are called in to investigate something weird (I think a murder is involved in all three, actually), the weird thing turns out to be a monster and, well, instead of stabbing it with swords, they shoot it with guns and probably suffer higher casualties than a regular D&D game. Maybe that works for you?

The key difference between Gothic Earth and our own is the presence of the Red Death, a not-quite-entity that taints everything with evil, encourages terror and creates monsters to run amok. If that reminds you of Mike Mignola’s Baltimore stories, you aren’t alone and I could actually see a campaign along those lines working with a bit of elbow grease. But you could probably do it with less work with a different system.

I’ve seen a lot of love for this box over the years, but it didn’t get a ton of support (two sourcebooks, one adventure anthology, a couple short scenarios in Dungeon and not a single full module to my knowledge), so I don’t have a good notion of how beloved it is. Feel free to let me know!