A tissue imaging system (200) for examining the medical condition of tissue (290) has an illumination optical system (205), which comprises a light source (220), having one or more light emitters, beam shaping optics, and polarizing optics. An optical beamsplitter (260) directs illumination light to an imaging sub-system, containing a spatial light modulator array (300). An objective lens (325) images illumination light from the spatial light modulator array to the tissue. An optical detection system (210) images the spatial light modulator to an optical detector array. A controller (360) drives the spatial light modulator to provide time variable arrangements of on-state pixels. The objective lens operates in a nominally telecentric manner relative to both the spatial light modulator and the tissue. The polarizing optics are independently and iteratively rotated to define variable polarization states relative to the tissue. The modulator pixels optically function like pinholes relative to the illumination light and the image light.