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The Starter Deck is a new item added in Rebirth.
The starter deck allows the ability to carry two Tarot Cards at once, as opposed to the usual limit of one. It also turns any future Pill drops into Tarot Cards, including those from Mom's Coin Purse. It also changes Isaac's appearance by adding five coloured spots on his forehead.
The five-coloured pentagram (red, blue, green white andd black) is a trademark of the card game Magic:the Gathering.