Infectious and undying, the Pariah’s given name has long been lost to the sands of history. Legend holds this lurching, bandage-swathed terror was the prince of a forgotten desert kingdom renowned for his foolishness and generosity. Now he is a looming figure, whip-thin, and covered in plague sores long since crusted over. This affliction gives what little skin is exposed amid rancid bandages a leathery texture, shavings of diseased flesh flaking off in the breeze. Wild eyes, brimming with madness and power, forever stare, their lids glued open with petrified canker.

Infectious Madness. Fragments of the Pariah’s tragic tale say that the now nameless prince was overcome with insane mirth when he realized he was the last living soul within his capital. They say he cavorted through the streets, leaping over corpses rotting on the ground, throwing handfuls of desert sand into the air as if it were confetti, and his cackling echoing like rolling thunder along of the city’s crumbling walls. The Pariah never stops chuckling, save to sputter cryptic prophecies. So tortured is the sound of his mirthless laughter it can derange the minds of those who hear it.

Festering Gift. Despite his hardships, the Pariah remains a generous creature. Unfortunately for civilizations he encounters his gifts come in the form of plagues. In his twisted world-view, the contagion that has granted him eternal life should be shared with all so they might have a chance at the same. Of course, no one else has survived the phage long enough to reach such a zenith. The broken, desperate and mad flock to the Pariah’s feet soon after his arrival as they are so desperate to believe in some form of relief even if it comes through great suffering. These lost souls become the Pariah’s court, minions he uses to disrupt the ‘corrupt’ powers that be in the area and spread the plague amid the chaos. In the end, everyone still dies except the Pariah and he moves on with a smile on his withered lips.

The Pariah

Medium aberration, chaotic neutral

Armor Class 9 (natural armor)

Hit Points 150 (20d8 + 60)

Speed 20ft

Str 19 Dex 8 Con 16 Int 15 Wis 17 Cha 20

Saves Con +7, Wis +7

Condition Immunities exhaustion, frightened, poisoned

Damage Immunities necrotic, poison

Damage Resistances blundgeoning, piecing, and slashing from non-magical weapons

Senses darkvision 120ft, passive Perception 13

Languages common, deep speech primordial

Challenge 11 (7200 XP)

Ceaseless Torment:

When the Pariah is destroyed his body and clothing dissolve into a pile of lifeless sand over 1d6 rounds. At the next sunset, he is resurrected in the desert-swallowed ruins of his forgotten capital and begins his wandering anew. Only a Wish spell can prevent this effect.

Diseased Spatter:

Whenever the Pariah is hit by a melee weapon attack all creatures within 5ft of it take 10 (3d8) necrotic damage.

Magic Resistance:

The Pariah has advantage on saving throws against spells and other magical effects.

Innate Spell Casting:

The Pariah is a 16th level spellcaster. His spellcasting ability is Charisma (spell save DC 17, +9 to hit with spell attacks). He requires no material components to cast its spells.

At will: Chill touch, infestation, mold earth

3/day each: Cause fear, crown of madness, ray of sickness

1/day each: Hunger of hadar, erupting earth, wall of sand

Actions

Multiattack

The Pariah makes three bandages attacks as one action.

Bandages:

Melee Weapon Attack: +8 to hit, reach 15ft., one target. Hit: 7 (1d6+ 4) bashing damage plus 7 (2d6) necrotic damage. In addition, the creature must make a DC 15 Constitution save or contract Sloughing Stain. Septic patches erupt across the creature's skin giving it disadvantage on Charisma saves and the creature gains a level of Exhaustion. At the end of each long rest, the creature repeats this save, gaining a new level of Exhaustion on failure, the disease ending on success. If the creature dies while infected with Slough Stain it's skin and meat pulls off its bones 1d6 rounds later, forming a Gibbering Mouther.

Spasmic Cackle (Recharge 5-6)

All creatures that can hear the Leper's cackle within 30 ft must make a DC 17 Charisma save or be wracked with seizers and fall prone, becoming incapacitated and unable to stand up for the duration. A creature with an Intelligence score of 4 or less isn’t affected.

At the end of each of its turns, and each time it takes damage, the target can make another Charisma saving throw. The target has advantage on the saving throw if it’s triggered by damage. On success or after 1 minute, the effect ends. On failure, the creature takes 7 (2d6) psychic damage that does not trigger a new saving throw.

Once a creature successfully saves against the Pariah's Spasmic Cackle it is immune to its effect for the next 24 hours.

Legendary Actions

The Pariah can take 3 legendary actions, choosing from the options below. Only one legendary action option can be used at a time and only at the end of another creature's turn. The Pariah regains spent legendary actions at the start of his turn.

Infectious Smile (1 point). The Pariah targets a creature he can see within 30ft that is also currently suffering from a disease and attempts to overcome its will with his unnatural charisma. The creature must succeed on a DC 17 Wisdom save or be Charmed by the Pariah for the next minute.

If the affected creature suffers any damage from the Pariah or one of the Pariah's allies, it may repeat this save with the effect ending on success.

Whip (1 point). The Pariah makes a Bandages attack.

Cackle (2 points). The Pariah uses his Spasmic Cackle action, if available

Royal Blessing (2 points). The Pariah casts the Contagion spell with a DC of 17, rolling randomly for what disease the target creature contracts on failiure. In addition, the creature heals 13 (4d6) hit points on failure, no healing on success.

Using the Pariah–

The Pariah is a force of nature. The Pariah is ancient and relentless. The Pariah is insane and thinks he is doing the right thing. In a campaign, the Pariah can be used as anything from a cult leader, to the figurehead of a mad revolution threatening to overtake the kingdom, or the good-natured despot squatting on a rotting nation’s remains. His madness is just as infectious as the alien plague he carries. The down-trodden and insane flock to his feet first, but as the plague spreads so does his influence. The worst thing is that he believes he is trying to make things better and sees all other authority figures and organizations as oppressors.

Or, a high-level party could be assaulted by the Pariah and a small cadre of fanatics as they cross and endless deserts. Maybe there is some artifact in the ruins of the Pariah’s lost capital that the heroes want but they have to deal with all manner of plague-encrusted horrors and then the Pariah himself. Remember, though, the Pariah always comes back.

Appropriate Minions

Any NPC, part of the Pariah's cult.

Crawling Claws

Death dogs

Earth Elementals (Sand)

Gibbering Mouthers

Jackalweres

Mummies

Swarms of Crows, Bats, Rats - with a diseased bite

Swarms of Insects (scarbs)

Wretched Sorrowsworn