"An oddly carved pumpkin that can be worn.
Halloween Exclusive"
Acquisition
Vile Pumpkin Head 4 (insert sources here).
Vile Pumpkin Head 4 is not directly dropped by Enemies.
Vanity
Vile Pumpkin Head 4 (insert sources here).
Vile Pumpkin Head 4 is not directly dropped by Enemies.