If you are experiencing any discomfort or black tongue, consult with a doctor as soon as possible. Because it is venous, it is benign and asymptomatic. This increased pressure in the portal veins may lead to swollen veins throughout the body. [4] Phleboliths or thrombophlebitis may complicate this condition. Here's what may be causing it and when to see. To try this remedy, rinse your mouth with a strong chamomile tea once it has cooled, or apply a wet tea bag directly to the sore spot. The diagnosis can usually be made on clinical grounds alone. Any information provided on the Trickycare platform is for general information only and does not constitute professional advice. There is a broad range of diseases that affects the tongue and its clinical analysis helps the physician to reach the diagnosis. 1 The majority of dermatologists do not have any specialized training in diseases or conditions of the mouth. Like skin cells, the cells on your tongue have a life cycle that allows them to grow,. In most cases, caviar tongue will go away on its own without any treatment. Caviar Tongue | Symptoms, Causes, Treatments, And Prevention. It is commonly noticed under the tongue along the sublingual vein, the floor of the mouth at the opening of the sublingual glands, and along the lateral, ventral (underside) of the tongue. Although it can be uncomfortable and hard to ignore, a sore tongue usually isnt a cause for concern. Sclerotherapy or surgery has been performed in a variety of locations, including the lips and buccal mucosae, in addition to single lesions. Could Be a Canker Sore, How to Identify and Treat a Cut on the Gums, OTC hydrogen peroxide rinses (Peroxyl, Orajel), blisters or sores on other parts of the body, irritation from braces or dentures, brushing teeth too hard, or, swollen taste buds (enlarged papillae), also called, vitamin deficiencies, such as vitamin B-12, iron, folate, niacin, or zinc, oral mucositis caused by chemotherapy and radiotherapy. Sometimes when you wake up in the morning and suddenly there is a small bump in your mouth that looks like an ulcer but a little bigger and appears to be filled with water-like fluid and painless. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. Retrieved from. But what if it doesn't? This is due to a condition known as plaque tongue, which causes enlarged purplish-black dilated veins that resemble those of a caviar. Apply ice to your canker sores by allowing ice chips to slowly dissolve over the sores. Sublingual varices are benign vascular dilatations, usually asymptomatic and affecting 10% of the population over the age of 40 years. Along with that, there may also be multiple or huge aggregating granulation tissues that may be observed. .switcher .option {position:relative;z-index:9998;border-left:1px solid #ccc;border-right:1px solid #ccc;border-bottom:1px solid #ccc;background-color:#eee;display:none;width:161px;max-height:198px;-webkit-box-sizing:content-box;-moz-box-sizing:content-box;box-sizing:content-box;overflow-y:auto;overflow-x:hidden;} Fish Poisoning - Johns Hopkins Medicine Vascular tumors like hemangioma and lymphangioma show endothelial cell proliferation and dilated lymphatics respectively, while Kaposis sarcoma shows tumor cells composed of vascular spaces and spindle cells on histology. It is a popular dish in many parts of the world, and its popularity is only increasing. Caviar tongue - Wikipedia Caviar tongue on histology is just a dilated vein with no inflammatory changes. (2010). Surgery or sclerotherapy has been performed in a variety of lesions and unusual locations, such as the lips and buccal mucosae. Diseases of the Tongue | SpringerLink .switcher .option::-webkit-scrollbar {width:5px;} Treatments: Most of the time, caviar tongue does not require any treatment since it's a harmless condition. Only clinical examination can diagnose the condition, which is known as caviar tongue or sublingual varices. Pasquale, M., Bierma, N. L. K. (2011). Deepak Kansal November 30, 2021 5798. We also use third-party cookies that help us analyze and understand how you use this website. The lesions usually appear bluish purple, with elevated blebs commonly seen on the ventral or lateral or both the borders of the tongue. Over-the-counter and home remedies are commonly used in treatment of sore throats. Hedstrm, L., Albrektsson, M., Bergh, H. Is there a connection between sublingual varices and hypertension? Read this article to learn about the etiology, risk factors, clinical features, and aesthetic management of caviar tongue or sublingual varicosity. There is no one definitive answer to this question. An oral ulcer is unlikely to require medical intervention, but medication may be required if there is an underlying infection. Trans Am Clin Climatol Assoc 1952;64:40-9. The throat is dotted with acaviar tongues. How is CoVID-19? Bean WB. The most common cancer in women is tongue cancer, while the second most common cancer in men is colon cancer. It can happen at any age, but its more likely in young adults. When this occurs, swelling of the face, neck, and dilation of the veins on the skin surface occurs.6, As to what else causes the larger, prominent blood vessels underside the tongue is not fully concrete. Antifungals, like fulcanazole (Diflucan) and clotrimazole (Mycelex Troche) are prescribed to treat oral thrush. 10, Corra PH, Nunes LC, Johann AC, Aguiar MC, Gomez RS, Mesquita RA. Consult your doctor before taking any supplements. It is also medically proven that patients diagnosed with sublingual varices or caviar tongue usually have other medical conditions like hypertension or cardiovascular disease. Neville, B.W., Chi, A.C. Developmental Defects of the Oral and Maxillofacial Region. Phleboliths or thrombophlebitis can cause this condition to worsen. It is possible that medication or surgery will be required to correct the underlying issue. Something went wrong while trying to load the full version of this site. You can rub a bit of honey directly on the sore area a few times per day or drink a warm tea with honey. Location, Causes, Diagnose, Complication and Treatment? All rights reserved. Only if the areas like lips or buccal mucosa are involved, then treatment is advised. Breathing difficulty ( asthma) Indigestion and stomach pain Belching, bloating, or flatulence Diarrhea Nausea or vomiting Symptoms may also develop by simply inhaling cooked fish or coming into contact with surfaces or utensils used to prepare fish. Necessary cookies are absolutely essential for the website to function properly. All have been suggested as predisposing factors, but researchers are unable to solidly prove it.2, A Saudi Medical Journal study focused on correlations or predisposing factors of sublingual varices with smoking, cardiovascular conditions, hypertension, denture wearing, and vitamin C deficiency.3 According to this study, a patient 40 years of age and older with sublingual varices has a 50% risk of being hypertensive. Caviar tongue is a rare condition that causes an intense burning sensation on the back of the throat. Your dentist or doctor will ask about your symptoms and look at yourmouthand tongue. He had no systemic complaints or past history of any major illnesses. +91-99-432-70000+1 (844) 432-0202 (Toll free for US & Canada), Published on Sep 07, 2022 Lining the undersurface of the tongue are clusters of small dilated and tortuous veins that may attain a large size, appearing round and black akin to caviar. This category only includes cookies that ensures basic functionalities and security features of the website. Hairy Tongue: Why It Happens and How to Treat It - Healthline The bumps are usually white or red and can vary in size. Save 1. Volume 3 [Central, Health] on Amazon.com. Another study found that healthy, non-medicated people ranging between 20 to 95 years of age had no oral changes with the tongue. Scrub gently with a toothbrush for a few minutes on your white tongue after putting some salt on it. In cases where the patient's esthetic appearance is compromised because of this condition, it can be easily treated with the methods mentioned above, such as lasers and sclerotherapy. Tongue coating - food debris, desquamated epithelial cells and . Caviar tongue occurs in a few different sites. Translate this page into: When the intolerance gets worse, the stomach may become empty, and the person may experience headaches. Asymptomatic hyperpigmented lesions on tongue, Dermoscopic features of a flesh-coloured papule on the, Figure 1 :Dilated tortuous vessels seen along the lateral portions of undersurface of the tongue. 15 Sore Tongue Remedies: Causes and When to Seek Medical Help - Healthline Consuming a lot of wine can increase venous pressure, particularly if the patient has portal hypertension or superior venacava syndrome. Ulcers may. Causes. What are the causes of caviar tongue? The tongue is also referred to as acaviariasis (plural) and acaviariasis (singular) due to the fact that it looks like varicose veins (Figure 1). This condition is often fatal because niacin contributes to the death of the white cells in the tongue. As an antiseptic, hydrogen peroxide can treat an infection or sore inside your mouth. dry mouth (xerostomia) medications. However, some people may experience a burning or tingling sensation when they eat caviar. By taking the right treatment and prevention measures, you can keep your tongue in good health and free of any signs. The characteristic feature of the caviar tongue on histopathologic and microscopic examination is the concentric arrangement of the erythrocyte and platelet layer called lines of zain. Similarly, black hairy tongue is a condition that is not as severe as black hairy tongue, but it usually resolves on its own. For pain and swelling, try rinsing your mouth with a mixture of warm water and baking soda (1 teaspoon per 1/2 cup of water). Ice has numbing qualities, so drinking ice-cold water or sucking on an ice cube or ice pop can help relieve some tongue soreness, including soreness caused by dry mouth, or a burning mouth. https://ijdvl.com/caviar-tongue/, Tags: Caviar Tonguesublingual varicositiestongue. However, the undersurface of the tongue is most often missed out on inspection. There is no effective treatment for primary amyloidosis. Furthermore, patients with mild to moderate infections had a light red tongue with a white coating that appeared discolored. Most causes of a sore tongue are temporary and arent serious. Despite the fact that caviar tongue is uncommon, it can be caused by a variety of factors, including allergic reactions, low iron levels, mouth trauma, dental appliances such as braces or dentures, dry mouth, and certain illnesses. Anemia of niacin Vitamin B3 can cause the development of a black tongue, also known as glossitis. A varix will feel firmer, similar to a BB pellet, beneath the mucosal surface. What Is the Management of the Caviar Tongue. DOI: Nutrition tips for managing sore mouth, throat, and tongue. The tongue is frequently associated with choristomas, a condition in which normal tissue is abnormally positioned in an abnormal location. Until the soreness goes away, avoid these foods. Analytical cookies are used to understand how visitors interact with the website. Its types, Indications, Cost and the Techniques? These bumps are also found on the underside of tongues, but they are less visible. NCBI WWW Error Blocked Diagnostic. [4] However, most of these conditions can be differentiated by a detailed history and thorough clinical evaluation. We present a case of this physiological change called caviar tongue. Sublingual varices may be occasionally confused due to resemblance to tumors like hemangioma, lymphangioma, Kaposis sarcoma, melanoma or other conditions like Oslers syndrome, blue rubber bleb nevus syndrome. As the virus spreads, you may develop a swollen tongue as a result of its worsening symptoms. These cookies will be stored in your browser only with your consent. As a result, the condition of caviar tongue, also known as sublingual varicosity, is benign and affects people of all ages. Geographic Tongue: Symptoms, Causes, Diagnosis, and Treatment - WebMD Poor oral hygiene and an excessive intake of sugary foods are frequently the cause of this condition. This is often because of things like: Geographic tongue happens when parts of your tongue are missing layers of papillae. .switcher .selected a:after {height:16px;display:inline-block;position:absolute;right:5px;width:15px;background-position:50%;background-size:7px;background-image:url("data:image/svg+xml;utf8,");background-repeat:no-repeat;content:""!important;transition:all .2s;} There is no cure for glossitis, but there are treatments available to manage the symptoms. Geographic tongue (benign migratory glossitis) - a common disorder which occasionally causes a burning sensation but is usually painless. If left untreated, this condition can be complicated by hemophilia B or hemophilia C. A correlation has also been found between angiokeratoma and the scrotum. Overgrown tongue can be caused by a variety of factors, including Beckwith-Wiedemann syndrome and vascular anomalies. What is Open Bite? You can also have it in other areas of yourmouth. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. In some cases, the cause of caviar tongue is unknown. The following article we'll discuss the symptoms, causes as well as treatments and ways to prevent caviar tongue. Elevated venous pressure, such as high blood pressure in the vein portal or superior venacava syndrome, can cause the formation of a plaque on the tongue. Multiple dilated veins and irregularly shaped structures, which can also be found on the lesions, are characteristic of this type of lesions. Caviar tongue - PubMed Caviar tongue is a condition that can occur when a person eats too much caviar. There are multiple dilated veins in the sublingual region, and they are irregularly shaped structures. Although age-related sublingual varices may be associated with systemic diseases, malnutrition, medication, and ill-fitting dentures.3,4. .switcher .selected a {border:1px solid #ccc;color:#666;padding:3px 5px;width:151px;} However, it may be a concern for certain people and negatively impact their self-esteem. 4.35). In severe cases, epinephrine may be necessary. Multiple . It may be an underlying systemic disease. Moschella's Dermatology. This website uses cookies to improve your experience while you navigate through the website. 3, James WD, Berger TG, Elston DM. Less common causes for a sore tongue include: vitamin deficiencies, such as vitamin B-12, iron, folate, niacin, or zinc. In the absence of treatment, it is considered a natural physiological change that accelerates aging. You can upload files and images in the next step. Veins are normally visible underneath (ventrally) the tongue since the mucous membrane is so thin and translucent. However, if it is present on the lips or the buccal surface of the mucosa, sclerotherapy or photocoagulation with a high-intensity laser can be performed for aesthetic purposes. You should see a doctor sooner if you have the following symptoms alongside a sore tongue: A doctor can find out if your tongue soreness is caused by an underlying condition, or if you simply need to make some changes to your oral hygiene routine. Most causes of a sore tongue, like canker sores, swollen taste buds, and mouth injuries, can be treated at home. The endothelium is hypoplastic but the wall is thick and cellular. Lara has created DentalAisle.com, a dental blog, to educate consumers on dental products and dental issues. .switcher {font-family:Arial;font-size:10pt;text-align:left;cursor:pointer;overflow:hidden;width:163px;line-height:17px;} Caviar tongue Indian J Dermatol Venereol Leprol. Veins are normally visible underneath (ventrally) the tongue since the mucous membrane is so thin and translucent. Caviar tongue can be a non-threatening condition that alters your tongue's appearance. It's called geographic tongue because the patch patterns resemble how land masses and oceans are shown on maps. A sublingual variation may be a sign of an underlying systemic disease. There is no scientific evidence to support the claim that caviar is painful on the tongue. However, with caviar tongue, the blood vessels become dilated and tortuous and appear round and black (resembling caviar). The ventral surface of the tongue is one of the most common sites for a definite diagnosis. This is the main theory or hypothesis explaining the dilated venous structures in the sublingual region. Caviar tongue photos are a type of food photography that is becoming increasingly popular. If the bumps are linked with an unrelated medical issue treatment of the underlying issue is usually able to resolve the caviar . These look like tortuous or aberrantly dilated venous structures, which the dental surgeon can easily recognize. Brushing your tongue or using a tongue scraper can help remove the food and bacteria. What is Frenectomy? The normal wear and tear on the oral cavity is the cause of tongue problems. Many systemic conditions might result in the Caviar Tongue. In most cases, black tongue does not need treatment and clears up in a short period of time. It is best to use salt to treat white-coated tongues. Some of these include. .switcher .option::-webkit-scrollbar-track{-webkit-box-shadow:inset 0 0 3px rgba(0,0,0,0.3);border-radius:5px;background-color:#f5f5f5;} Caviar tongue | Request PDF - ResearchGate Coconut oil may be able to heal a sore tongue because of its antifungal, antibacterial, and antiviral properties. These cookies track visitors across websites and collect information to provide customized ads. Disorders of mucous membranes. 2005 - 2023 WebMD LLC. This can happen for a variety of reasons, including certain .switcher a {text-decoration:none;display:block;font-size:10pt;-webkit-box-sizing:content-box;-moz-box-sizing:content-box;box-sizing:content-box;} But opting out of some of these cookies may affect your browsing experience. Last medically reviewed on October 12, 2018. I am a Dental Professional, Acquainted Content writer and creator, Imparting valuable dental knowledge through trickycare.com and working towards making a difference. The surface of these lesions appears to be tan, blue, purple, or black and can be raised, flat or oval. Along with soreness, the tongue can have: If the soreness or pain lasts more than two weeks, or presents itself with other bothersome symptoms, see a doctor. Disorders of oral cavity. (2006). Common Sites Involving Sublingual Varicosities are: Ventral surface of the tongue ( most common site, hence, the name is caviar tongue). the term "caviar tongue" is sometimes used (Fig. An association with angiokeratoma of scrotum has also been reported. Burning your tongue can be painful and frustrating. Caviar tongue is a condition that can occur when eating certain types of fish, such as sturgeon or salmon. What Are the Risk Factors Involved in Caviar Tongue? As a result of its physiological significance and benign nature, chiavara tongue does not necessitate medical attention. Superior labial frenum:- It attaches the upper lip to the gums of the maxilla. A caviar lesion is a small, raised lesion that is filled with fluid. Caviar tongue. Bilateral plaque on the tongue is a benign venous disease that is usually asymptomatic. Caviar tongue is a condition that can be caused by a number of different things, including a reaction to certain foods or medications, an infection, or a more serious underlying medical condition. Caviar tongue. Today's Digital Media, LLC d/b/a Today's RDH, Caviar Tongue: Are Dental Hygiene Patients Displaying Signs of Aging?, http://www.ijdvl.com/text.asp?2011/77/1/78/75002, https://pdfs.semanticscholar.org/c293/3d66c8974d1ea60ee99ddf926e205fab498e.pdf, https://www.sciencedirect.com/topics/medicine-and-dentistry/varices, https://doi.org/10.1186/s12903-015-0054-2, https://www.medicinenet.com/superior_vena_cava_syndrome/article.htm#what_is_superior_vena_cava_syndrome, Fluoride Varnish vs. If you have dry mouth, there are prescriptions available to help increase saliva production. Caviar lesions are benign, but can be uncomfortable and unsightly. In some cases, caviar tongue may be a sign of a more serious condition, such as oral thrush. It can be clinically firm or compressible. Caviar tongue is a condition that can occur when eating certain types of fish, such as sturgeon or salmon. Tongue issues caused by infections, like oral thrush, or syphilis, will likely require a prescription to get rid of the infection, so dont delay making an appointment. Symptoms: The most obvious sign of Caviar Tongue | Symptoms, Causes, Treatments, And Prevention is the appearance of small raised bumps on the tongue. Akkaya, N., Olmez, D., Ozkan, G. Evaluation of the factors associated with sublingual varices: a descriptive clinical study. Some home remedies may also ease the soreness, depending on the cause. But if you have severe, constant pain,medicationcan help. Fig. However, because geographic tongue tends to run in families, it might have something to do with your genes. Other tongue diseases and problems that can occur include canker, sores, oral lichen planus, and tongue trauma. There was no history of bleeding from the site. Braz Oral Res 2007;21:40-5. Caviar tongue is a condition that results in the tongue having a bumpy, rough texture. Sublingual varices are not unusual. Ventral surface of the tongue ( most common site, hence, the name is caviar tongue). A thorough examination of the tongue helps in identifying systemic illnesses like hypertension, anaemia, diabetes Mellitus or precancerous lesions like Lichen Planus or some other fungal infections like drug-induced oral candidiasis in patients undergoing chemotherapy or tumours such as Kaposis sarcoma, lymphangioma or haemangioma etc. Reversing Caviar Tongue: Overcoming Cravings The Raw Vegan Plant-Based These patients present with dilated blood vessels on the tongue called varices. As one gets older, the lingual varicosities and sublingual veins of the tongue are thought to age as well. Others may be required to take steps to prevent the underlying cause of the problem in the first place. The accumulation of protein keratin on the tongues surface is usually what causes black tongue. Treatment. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. Physicians recommend sclerotherapy alongside photocoagulation and high-intensity diode lasers for esthetic rehabilitation. If the bumps hurt or itchy, over-the counter pain relievers or topical creams can be applied to relieve the symptoms. It could also be caused by a bacterial or viral infection. Prevalence of oral hemangioma, vascular malformation and varix in a Brazilian population. When bacteria or fungi in the mouth overcompensate, it can cause the tongue to blacken. Causes: The reason for the caviar tongue is not known. 2011 Jan-Feb;77(1):78-9. doi: 10.4103/0378-6323.75002. The underlying cause may be a systemic disease. Dab the affected area using a cotton swab. Caviar tongue is also referred to as sublingual varices (plural) and varix (singular) and look like varicose veins in the tongue. Brushing your teeth with a soft toothbrush, flossing, and using a mouthwash can help rid yourself of a sore tongue and prevent infection. -3 min read. You might need a prescription vitamin supplement, like a B-12 shot, folate, or iron to help treat a vitamin deficiency. It is a benign, asymptomatic, venous lesion.1. Only if the areas like lips or buccal mucosa are involved, then treatment is advised. Alqareer A, et al. What is Mucocele? Location, Causes, Diagnose, Complication and Treatment? [6] This condition has been reported to highlight this rather interesting and benign physiological manifestation of aging process which is infrequently looked for by a dermatologist. In: James WD, Berger TG, Elston DM, editors. Do you have a question on Caviar Tongue or ? Due to the dilated blood vessels, the flow of blood will slow down, causing a higher risk for thrombosis. Numbness of face and extremities. The more pigmented skin on ones face, the more visible is their mouth. . ", American Academy of Oral Medicine: Geographic Tongue., National Organization for Rare Disorders: Geographic Tongue., American Academy of Oral Medicine Photo Caption, National Organization for Rare Diseases Photo Caption. Your doctor will prescribe an antibiotic to treat the infection. This condition can also be found in the labial mucosa, lip skin, buccal mucosa, and other oral locations. When sublingual varicosities are seen in younger age groups it is presented as a sign of early ageing (premature ageing) which may be an indicator of some underlying systemic disease. Geographic tongue can be treated with a variety of home remedies. Tongue disease - Wikipedia The signs of geographictongueare uneven red patches. To distinguish this condition from other malignant lesions, dental healthcare providers must conduct a comprehensive microscopic and histopathologic examination. How To Make Your Own Greek Souvlaki Seasoning A Quick And Easy Way To Add Greek Flavor To Your Meals! The reasons for it might be anything from. Frenum (plural: frena) is a loose fold of connective tissue that attaches gum, underlying periosteum or alveolar mucosa to the lips, tongue or cheeks. (n.d.). [1] Uncommon sites are lips and buccal mucosae. FP are cone-shaped projections on the surface of your tongue. More advanced treatment options include antifungal medications, mouthwashes or retinoids (derived from vitamin A). Make sure to take the full course of antibiotics, even if you start feeling better. Home remedies can also help you ease a sore tongue caused by more serious medical conditions, such as burning mouth syndrome or oral thrush, as part of a medical treatment plan. While caviar tongue is not a serious condition, it can be uncomfortable and frustrating for those affected. When the underlying medical condition is the source of the tongue problem, treatment may be required. The headache may become more severe within a few days, and the person may experience a fever and swollen tongue. However, if the condition is caused by an underlying medical condition, it may be necessary to seek medical treatment. Learn more, A tingling tongue usually isn't anything to worry about and will clear up soon. Visit other versions in US, UK, Australia, India, Philippines and Home If your symptoms persist for an extended period of time, you may require a medical appointment with your doctor. They're usually about 1 millimeter (mm) long. A healthy tongue should be pink and covered with papillae, which are small bumps. Discover its ingredients, how to take it, alternatives, A canker sore isnt contagious. Here we promise you that your search will end up, as we give you access to supportive information, credible references, and community help for the health and dental care you are looking for. .l_name {float: none !important;margin: 0;} You might have them for up to a year. The lesions are commonly seen as a physiological change in connection with age.4 During the aging process, the changes with the blood vessels and connective tissue in blood flow may change the arterial pressure at the arteriovenous shunts. This is called oil pulling. What is Frenectomy? Its types, Indications, Cost and the Techniques? It seems that the pain is caused by the small, sharp eggs puncturing the taste buds on the tongue. PMID: 21220892 DOI: 10.4103/0378-6323.75002 No abstract available. It is an excellent home remedy for treating ulcers and sores under your tongue caused by witch hazel. However, it can also be found on the labial mucosa, lip skin, buccal mucosa, or other rare oral sites such as oral mucous membranes. Discover causes, how it compares to a cold sore, prevention tips, Magic mouthwash helps treat mouth sores caused by conditions, such as cancer and oral thrush. 13520 Aurora Avenue North - Seattle, WA 98133, How Much Sturgeon Caviar Produced In The World, Caviar Vs Cod Roe: A Luxurious Comparison, Adding An Escargot Begonia To Your Home: Everything You Need To Know, Catch The Elusive Gyro Creatures Of Sonaria A Guide To Becoming An Expert Gyro Creature Catcher, A Classic French Delight: Chicken Bourguignon, The Dangers Of Ratlung Worm: What You Need To Know About This Rare Parasitic Infection, The Ultimate Guide To Eating Escargot In Paris, Adding A Splash Of Cognac To Beef Bourguignon: Pros Cons & Recipes To Try, How To Make Restaurant-Worthy Beef Bourguignon In Your Pressure Cooker, A Taste Of History: Picking The Perfect Wine To Pair With Cassoulet.