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I did also think a lot about these accessible tag clouds a while ago, in french for those who can read it: http://www.gasteroprod.com/comment-faire-un-tag-cloud-nuage-de-tags-ou-d-etiquettes-accessible.html
Like Ben Ward, I also chose to use EM and STRONG elements, but without nesting them. I feel it to be as improper as nesting EM with another EM.
I think there is a need (and I would be really happy to contribute) for a microformat for tagclouds, starting with John Allsopp’s work (also available here http://microformats.org/wiki/tagcloud-brainstorming) and all your comments!