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Spades: Kill the Lamb without taking any heart, coin or bomb in the whole run.
Hearts: After Basement1, do a full level with only half a heart (you can use the Lost).
Clubs: Get a 3-win streak.
Obviously, no seed or mod allowed, and won't work in a challenge or daily run, as usual for any unlock.
Spades is the only hard sounding one. Like it sounds extremely hard because how easy items can drop near you, explode onto you, ect.
Like theres the 1x1 path where an item might spawn. Then theres the room with the two switches and shooting heads that mean you have to clear the poops.
I didn't check it myself (yet). x)
And for diamonds you better need to kill the Lamb (cause I know that with other bosses it can be bugged).
Pre-Afterbirth Lost was easier. T_T
For clubs, do three runs and have a good time!
For hearts, do two floors with the Lost!
For diamonds, do a speedy Azazel run!
For spades, undo years of Isaac muscle memory and fear the very pickups you've prayed to the RNG gods for.
No amount of keys is worth this. The 2-3 keys you'd get from using ace of spades anyway.
Note: You can still get Bombs from Bomb Items (Sad Bombs, etc), you can get Coins from A Quarter and A Dollar, and you can get Soul/Dark Hearts from Book of Revelations and Satanic Bible. So you can *have* these things, you just can't take them as Pickups.