Patients with acne vulgaris and subclinical dermographism constitute a distinct, common, and hitherto unrecognized group. One hundred and thirty such clinical patients were observed in a private dermatology practice. These patients relate that their acne produces the symptoms of itching, burning, soreness, and/or tenderness. The lesions are characterized clinically by one or a combination of the following signs: erythema, violaceous discoloration, ecchymoses, and a scarlet to livid halo about the pustule or inflamed closed comedone. I tested for the dermographic phenomena in patients with acne both entering and already being treated in a private dermatology practice over a two-year period. Patient’s age, sex, whether or not dermographism predated or postdated onset of acne, symptoms of lesions, premenstrual flare, and history of atopy were recorded. Most patients were between the ages of twenty and forty years, and the majority were women. All had symptomatic lesions, and a significant minority noted no prior dermographic capability. The vast majority of women had premenstrual flares. A greater number of these patients were atopic than had been anticipated. The nonsedating antihistamine terfenadine mitigated both the signs and symptoms of the process. The syndrome of acne vulgaris with dermographism presenting as a unique visual and symptomatic variant of common acne is frequently seen, easily recognized, and highly treatable.