Surprisingly for me, the first time I ever saw the fleshchild in the second offshoot in th luggald caves, he dropped the earring. It's easiest to harmony (for me, a druid that practically farms Dulak) all his buddies and let them watch while i kicked his butt. Just dot rotted him to death... quite a bit more hp's then the other mobs and he likes to break root, but other then that no problem.
I have seen this a few times in the bazaar on my server (Tholuxe Paells) for 20k+. 2 nites ago a trader had it for 10k, when I noticed he was not AFK I asked him if he could do better. I got him down to 6.5k and bought it.
I was very happy to get this for my necro. Up to lvl 48 I was fine b/c there are plenty of Aff Eff II items in game. But once I hit 49 I found that there are not many droppable III or IV items. For a necro Aff Eff is a must since you use 80% of your mana on Dots and this focus saves 25%. I was planning on getting a ceramic hammer since I didn't think I'd find this for a reasonable price. But I'm glad I got this b/c ceramic hammer is primary/secondary only and has crap stats. Since some of the best stat items are primary secondary, the ceramic hammer would force me to sacrifice stats. So I'm very happy to get this. Gonna get the cermic skull for affl haste and put that in range slot. Its reasonably priced.
Now all I need is a good burning affliction III or IV item and an extended range 3 or 4 item.
What you have that looks like a card is an Insignia of Suffering which is used in a charm based on Emerald Warrior faction. Those drop off about half the luggalds in the tunnel and chambers as an uncommon to rare drop. This earring drops about as often as Vurag's tooth, painfully rare if yer lookin for one to use.
its not duplicate if you read carefuly the one that has a card design that is (Insignia of Suffering - for charm quest) then the one that has a skull look like earring is (Trinket of Suffering)
I too got a "Trinket of Suffering" in Nadox, and can confirm it looks like a card and it is NOT an Insignia of Suffering. I identified it and it is still a "Trinket of Suffering". Not sure if its for anything, but it sold to a vendor for over 90 platinum (thats always good) =)
It looks like a purple playing card with a gold K on it. My guess it is a place holder for items that where yanked from the drop table or planned to be implimented into the table later.
Got a trinket of suffering off of either luggald initiate or luggald abomination in Nadox. My fried looted one in same place as well...only problem is the trinket of suffering i got was a card looking thing, not anything you can equip,, is it merchant trash or quest item?
best spot if your soloing is after u pass the bridge turn right on the first turn follow the hallway straight u will soon see two campfires.
First one is the luggald assassin (very nasty dude) second camp is the fleshchild (ph is a blackblood of suffering... i think) it just looks like the dude with armor.. good luck on Fleshchild though hes abit long random spawn and drops very rare the earring