A 71 years old male with a history of myelodysplastic syndrome (refractory anaemia) starts with hematuria and pancitopenia a bona marrow aspirate is perfor with diagnosis of acute myeloid leukaemia.

He has the background of a bypass cardiac surgery and history of depression. a treatment with low dose of cytarabine is initiated and 3 months after starts with skin lessions. A skin biopsy is perform with a report of infiltration by acute myeloid leukaemia