“Pickman’s Model” is a good little Lovecraft story, and I also like Robert Barbour Johnson’s sequel/riff on it written not too long after Lovecraft’s death, Far Below. As a fan of “The Dream-Quest of Unknown Kadath,” of course, I know that the ghouls are really just adorable softies deep down (when they’re not eating people), and even in the original story there is a strong vein of black humor, but it’s still a strong horror concept. And of course, there’s no need for the “Dream-Quest” ghouls and the “Pickman’s Model” ghouls to be consistent: Lovecraft’s universe is like fractured mirrors giving many different reflections of the same few names and concepts.
The first artist I think of when I think of ghouls is, not Pickman, but Tim Kirk, a onetime assistant of Richard Corben, who drew several really mind-blowingly cool ghouls in Meade & Penny Frierson’s fanzine “HPL.” I’m undeniably influenced by his drawings. His ghouls, like mine, are VERY big and animalistic, leading to some question as to how they could ever have passed as humans, or just how much mutating it takes to get from Point A to Point B. But when in doubt, I say, go with more mutating.
Today I’m working on King of RPGs and on the next page of “The Doom That Came to Sarnath.” If you’re interested in having me draw something for yourself, feel free to commission a sketch! I’ll draw pretty much anything, especially Lovecraftian creatures.

I admit that my conception of ghouls as Lovecraft described them are a little different. The scaly hands, semi-hooved feet (more like primitive horses feet with each digit having a little hoof ) but we can draw the faces and heads as we like. Some would have more human look to them than others. It is implied that the Changelings alter faster among their already formed brethren. The infection that triggers the change along with feeding on carrion also would activate the metamorphosis. It is the “rubbery” part that I’m not sure of how to depict.
I’m not sure about the ‘rubberiness’ either. I think it means their flesh/skin is, well, rubbery… I’m thinking of a certain tautness or elasticity or fat deposits… or the texture of a tire… like it’s slick and oily and shines in the light…
Faces-wise, I agree, ghouls should have a huge variety of faces! Though I tend to draw them rather dog-like or werewolf-like… but the ones who still look humanish are grossest.
I would suggest that the giant one is a well fed ghoul. they have very long lives and can grow or shrink with the available food sources. They like it rotten over fresh. Like maggots who will only eat dead flesh. You want to gag a maggot, give them fresh living meat.
Are you suggesting that doctors should use ghouls, like maggots, to clean wounds? ^^