Efficacy was assessed in the pooled treatment group ( adalimumab with or without calcipotriol plus betamethasone dipropionate ) by Psoriasis Area and Severity Index ( 75 % improvement ; PASI 75 ) , Psoriasis Scalp Severity Index ( PSSI ) , Nail Psoriasis Severity Index ( NAPSI ) , Dermatology Life Quality Index ( DLQI ) and a visual analog scale ( VAS ) for pain .