24-year-old male patient, farmer and resident in Bom Jesus de Realeza-MG. About 3 months ago noted a progressive increase and fistulation of lymph nodes in several chains, associated with vomiting, weakness and weight loss of 6 kg. The patient developed skin lesions on face and neck (Image 1), multiple episodes of seizures, headache, sudden hypoesthesia and paresis of the lower limbs, urinary and fecal incontinence. Physical examination identified fever and discreet hepatomegaly.

 

 

Question:
Based on the clinical information and images shown, which is the most likely diagnosis?