Item:Silver Flame Nugget

The Silver Flame Nugget is not a (usable) item, but a quest - of sorts. You are given a Silver Flame Nugget, which you can then upgrade into a progressively more valuable necklace at the end-quests of the various Litany of the Dead chains parts 1-4, aka Necro 1-4. There are a total of 4 possible upgrades (although most players only do the first 3).

Each of the Necropolis 1-4 quest chains allows a progressively higher upgrade tier, so you could only upgrade to the Silver Flame Amulet in Necropolis 1, etc. However, you can do any lower upgrade at the end of a higher level quest chain. So, if you only want the Level 3 upgrade to a Silver Flame Talisman (the most popular option, by far), you only need access to the Necropolis 3 quests - but you'd have to run the end quest 3 times.

Silver Flame Nugget

 * This quest requires access to any part of The Necropolis story arc. Talk to Jakob Izakanos in the Necropolis to acquire this quest and the Silver Flame Trinket.
 * This is a 4-tier item that needs to be upgraded in certain altars at the end of each quest series.

First Upgrade
This can be done at The Bloody Crypt (Necro 1), The Shadow Crypt (N2), The Cursed Crypt (N3) or Accursed Ascension (N4) altars.
 * Silver Flame Amulet - Necklace:

Second Upgrade
This can be done at The Shadow Crypt (N2), The Cursed Crypt (N3) or Accursed Ascension (N4) altars.
 * Silver Flame Pendant - Necklace:, Deathblock

Third Upgrade
This can be done at The Cursed Crypt (N3) or Accursed Ascension (N4) altars.
 * Silver Flame Talisman - Necklace:, Deathblock, Protection from Evil

Final Upgrade
This can only be done at the Accursed Ascension (Necro 4) altar. The Silver Flame Talisman will become a simple gem again. Talk to Jakob Izakanos to get any one of the following quest completion rewards: