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It is one of three new endgame pinnacle bosses in Path of Exile 3.28 Mirage alongside the Incarnation of Fear and the Incarnation of Neglect. Defeating all three rewards the Originator Voidstone which unlocks Exceptional Support Gem drops from specific Atlas bosses across the endgame.

All three Incarnation kills are required together to obtain the Originator Voidstone. Dread completes that requirement. Without it the Voidstone does not unlock regardless of how many other endgame bosses you have cleared.

Socketing it into your Atlas enables specific bosses to start dropping Exceptional Support Gems. These gems replaced the Awakened Support system entirely in 3.28 and are essential for endgame build completion in this league.