This novel is thinly plotted Torture Porn. All scenes involve either torture/ graphic murder, graphic sex of various kinky varieties, urination, defecation or a combination of any and all of these.
Most of the characters manage to be porn stars or serial killers, all of whom have sexually degrading episodes from their past that get used to fill the pages between almost plot-relevant scenes of equally degrading torture porn. The few other characters are not left likable either in that they have no backstory or development or no redeeming qualities. One’s meant to like the police officer who apparently thinks it was okay to punish her husband for masturbating by anally raping him with a nightstick in a non-consensual way. This, described graphically multiplied by all scenes of the book = Hell Dancer.
Lovecraftian elements are window dressing, ultimately not building any true sense of a multi-dimensional world of horror.