Hitler's Toupee

A small, poorly placed hairpiece with a dark history. STR+2 and DEX+2 are solid offensive gains, but Permanent Madness is an unremovable debuff that persists for the run. StatusEachTurnEnd also fires a status effect every turn, providing constant passive pressure on enemies. For builds that can exploit or ignore madness mechanics, the stat gains and free status proc can outweigh the sanity cost.