Rafaria has the same ability with Esmeralda but has a weaker effect. However, she doesn't need luck to obtain as she is a monthly compared to the epic Esmeralda.
Although Lacerate has a different name and picture, it is considered to be the same ability as its effect is similar. Thus, it cannot be used together with Wound.
Best use against low health players although it's more ideal to wait and see who are the focus of the crossgate Healing and Reviving clerics. They will more likely to bring them back to full health so slashing their max health down could be useful, assuming they don't have titanic health of 5000+.
As the opposite of Fortitude, this ability is underwhelming at best. Decreasing max health doesn't mean much if active players could hardly have full health for the entire battle anyways. Also, with the existence of players with super high health in the realm of 10k's, the decrease of this power is negligible to them.
However, if you can roll this quick on Wrath Chest when you reach level 250 this can be one of the best abilities.