At work there are more computers infected with malware than letters in this post. Most of the nasty ones disallow Administrator rights and also disable the Control Panel on Vista/XP.
A quick easy fix for creating a new user without the use of the control is this:
Open a 'cmd' prompt through run. I have not tried through use of 'command' although I believe it would work the same.
Type the following:
net user /add Admin 123
net localgroup administrators Admin /add
net share concfg*C:\\/grant:Admin,full
net user Admin *
This will create an administrator account called useraccountname with a password of mypassword. The account can be created without a password as well.
If you need to delete the account use the same code as mentioned in line 1, but insert 'delete' where 'add' was used.