Death's Hand

Death's Hand is an NPC in UnderMine. He can be found after defeating Seer, World's Heart, the boss of the Golden Core.

When the Peasant talks to it, Death's Hand explains that they have reached the end of the run. The nearby can be collected. It is replaced with the if any of the bosses at that ascension level were skipped.

Dialogue
When you find a in the Endroom