Atypical leukemia with neuro_dermat manifestation
29 y/o male with history of autism , seizures and parkinsonism syndrome who present with 5 day history of developing new nodular erythematous lesions in trunk and limbs , fever and headache . history provided by parents .
medications include lamictal , #methylphenidate and sinemet . No recent sick contact . No recent medications . No other significant medical history . Physical examinations revealed crepitations in lower lobes bilaterally and nodules . Vital signs all with in normal limits . pictures are of skin biopsy . CXR reveals bilateral pleural effusions . what is your diagnosis , management plan and prognosis ?