Benighted SoulMolekale"It's me, and not"Passive item
The effect is determined by the last gained item's quality, except for itself:

• Q0: Spawns a bomb and a key for any new item picked up.

• Q1: 6 killed enemies spawn a coin; 3 picked coins heal Half Red Heart.

• Q2: When hurt or entering a new Boss Room, spawns a Blood Clot ( Sumptorium).

• Q3: When changing rooms, Isaac becomes invincible for 5 seconds.

• Q4: Enemies around get the Brimstone Curse; attacking is accompanied with homing Anti-Gravity + Brimstone lasers.
Unlock: Defeat ??? on Hard Mode as Benighted Eden.
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Download the Benighted Soul mod for The Binding of Isaac