Have you looked into the module Win32::NetAdmin available on CPAN? Specifically, look into the UserCreate function. Here's a snippet from the POD:
in reply to Unix Script to create NT accounts?
UserCreate(server, userName, password, passwordAge, privilege, homeDir
+, comment, flags, scriptPath)
Creates a user on server with password, passwordAge, privilege, homeDi
+r, comment, flags, and scriptPath.
Take a look over the POD documentation, and if you need any assistance in implementing this in your code, just let us know.