Exacerbate

You instantly worsen a creature's existing condition, harming it in any number of ways.

If the target is on fire or has suffered fire damage since your last turn, the flames redouble and it takes 1d6 fire damage.

If the target is poisoned or suffered poison damage since your last turn, the poison surges and it takes 1d4 poison damage, and is poisoned for 1 (additional) round.

If the target has suffered lightning damage since your last turn, a residual bolt jumps from it to the nearest creature, dealing 1d4 lightning damage to both.

If the target has suffered acid damage since your last turn, the acid reactivates and it takes 1d4 acid damage, and the space(s) it occupies become difficult terrain if it is on the ground.

If the target has suffered thunder damage since your last turn, it is wracked with a secondary shockwave that pushes it 5 feet away from you and deals 1d4 thunder damage.

And, finally, for each effect that triggered upon casting this spell, the target takes 1d4 force damage.

Special: When cast as a ritual, all instances of "since your last turn" instead apply if the condition has been met at any point during the spell's casting.

At higher levels, the force damage at the end increases by 1d4 for each level above 1st.