[Pneumomediastinum and diffuse alveolar pain. Severe interstitial pneumopathy due to dermatomyositis]. / Neumomediastino y daño alveolar difuso. Afección pulmonar severa por dermatomiositis.

We have recently observed the case of a 36-year-old man with dermatomyositis of recent onset, who developed masive pneumomediastinum and subcutaneous emphysema at the onset of a progresive and severe pulmonary disease. Although there were no sign of parenchymal cysts, after the bronchoscopy it was possible to observe endobronchial necrotic injury which was considered as the likely source of the air leak. He was treated with high dose of corticosteroids, cyclophosphamide and cyclosporin A which resulted in the disappearance of the pneumomediastinum and subcutaneous emphysema and the progressive improvement of both parenchymal lung disease and respiratory insufficiency, enabled us to progressively taper the dose of corticosteroids.