This skill synergises well with the necromancer elite Virulence. This will lead to a cheap, easy spike of over 100 damage.
Consider using Twisting Fangs as your dual attack. It will add two conditions at once, giving very little time to remove them before you use the Signet. Temple Strike can also be used, but has the disadvantage of being elite.
The following table lists the number of conditions needed to achieve the maximum damage of 130:
Anomaly! While the description of this skill says it is an attack, it clearly is not.