Ok, this is final Nylarthothep variant for this panel. Which is ironic (maybe?) as this was actually my first version when I started to create this monstrosity.
This version is the one that I wanted to add shoulder spikes to while making the tentacle hands become like other heads. This was also where I started adding patterns to the body, which carried over to another design and where I stretched out the creatures mouth to extraordinary lengths to show the mouth tentacles and made a third leg out of a tentacle/tongue combo. And that about concludes my description for this madness sense of deja vu design.
Oh, and the medium I used is pencil, overlayed with brush pen ink and cool/warm brush pens.