In this usage, there is no difference between さん and ちゃん. They are forms of address or title. Generally, however, さん is used for anybody while ちゃん is for a child or a girl. "お + an insulting noun meaning someone's character + さん", this construction expresses someone's character softly. But only a few nouns can be used this way. As far as I know, they are "chibi", "baka", and "debu(fat)" only.
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