To the Editor.—
I read Dr Gaeuman's letter with great interest. I have previously described identical lesions in a father (52 years old) and son (14 years old) who are engaged in installation of automatic garage door openers. They obviously spend most of their day on the ladder. Indeed, it was the father who suggested the name "ladder shins."1I agree with Dr Gaeuman's suggestion of not redesigning the ladder, but carpeting the ladder rungs is the easiest solution and will avoid the need for each person to wear shin guards. The carpeting should be done by the employer irrespective of who uses the ladder. Incidentally, the father had episodes of cellulitis in these lesions prior to carpeting the rungs and none since.1It is noteworthy that both the diagnostic name "ladder shins" and the appropriate treatment (carpeting the rungs) were suggested by the patient.
Rao DS. Shin Lesions From Ladder Rungs. JAMA. 1984;252(11):1407-1408. doi:10.1001/jama.1984.03350110013008