My goodness. I've seen this a while ago, but it's taken me a while to post because I've been left so speechless by this insane rendition of a well-known cartoon.
Your detail is incredible. I definitely think your ability to draw such realistic human skintones is a big part of what makes this piece. Patrick might have looked pretty freaky with the rough exterior of an actual echinoderm, but there's something gloriously uncanny about seeing skin like this on this adipose monstrosity which doesn't belong in human hide. The fact that this skin bears all of human skin's imperfections right down to the hairs makes this all the more eerie. I'm also really impressed by the lettuce, the detail in it is wonderful.
Your use of gleam is nothing short of fantastic. The hungry glint in Patrick's eye as well as his glimmering razor-sharp fangs makes him look truly ravenous. And the drool is masterfully done as well.
I think this picture resonates with me because I personally don't find the breed of fat, dumb, gross-out-humour-based characters that are featured heavily in a lot of cartoons and comedies today fun to watch. I think I find your drawing to fully illustrate the horror this archtype is to people who find it increasingly taking over media. Great job rendering this ferocious fatso.