paint directly onto uv texture?

How would I texture paint with alpha stencils like this in blender?
link - https://cdna0.artstation.com/p/assets/images/images/003/388/496/large/jonas-ronnegard-image01.jpg?1473173928


This is for substance, but it should be possible in blender right?

edit: can I sculpt and texture paint with 1 stroke?

edit: can I sculpt and texture paint with 1 stroke?
Sculpting is done on sculpt mode and texture painting is done in texture paint mode. You cannot be in 2 different modes at once.

You can load brush textures in the texture panel for use in texture painting or sculpting

say I use a height map brush pattern in sculpt to ‘pull’ a shape out of a mesh
I would also want the same texture applied at the same place on the uv map

what about some way to ‘save’ the strokes applied to sculpting and then place textures at those same locations? (so the sculpt map aligns to a diffuse map and others?)

we need this.